Two-stage treatment (Mukai's method) with hybrid 2-port HALS (Mukai's operation) for complete bowel obstruction by left colon cancer or rectal cancer

Oncol Rep. 2010 Jul;24(1):25-30. doi: 10.3892/or_00000824.

Abstract

During the initial emergency operation, a temporary loop colostomy (TLC) was constructed at the oral border of the region for subsequent radical resection. Then, radical surgery was performed by hybrid 2-port HALS (Mukai's operation) using the TLC as the hand access site. Left hemicolectomy was done in three patients, sigmoidectomy in two cases, low anterior resection in one case, and Hartmann's operation in one case. Radical surgery was not done in one patient with multiple distant metastases. The mean operating time was 3 h and 7 min (ranging from 1 h and 55 min to 3 h and 47 min), the mean blood loss was 146.4 ml (7-354 ml), the mean duration from TLC to HALS was 11.3 days (8-16 days), and the mean hospital stay after HALS was 13.9 days (9-20 days). Mild wound infection occurred postoperatively in 2/7 patients and ileus occurred in one patient. However, there was no anastomotic leakage/stricture or conversion to conventional laparotomy. These results suggest that 2-stage treatment (Mukai's method with Mukai's operation) is also applicable to large obstructing left colon or rectal cancers. This method is safe, less invasive, and achieves excellent results, including a good cosmetic outcome.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma / complications
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Colorectal Surgery / methods*
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / methods*
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Models, Biological
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology
  • Rectal Neoplasms / complications
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Time Factors