3. Study on Obstructing Carcinoma of the Large Bowel

A clinical and pathological study has been made of 30 obstraucting carcinomas (11.0 %) of 272 patients with colorectal carcinoma which were experienced at our hospital during the 15 years period from 1965 to 1979.1. Of 30 cases, sixteen were females (53.3 %) and 14 males (46.6 %). The age ranged from 39 to 86 years, with an average of 61.5 years. 73.3 % of the tumors located in the left colon compared with 26.7%in the right colon. The average duration of symptoms was 3.6 months.2. Ninteen cases were received resection of the primary lesions (resectablity 63.3%) and 38.3% were curative resection. All of the right colon cancers were treated by primary resection, but in 13 left colon cancers, 7 were subjected to primary resection followed by primary anastomosis, 4 end colostomy following Hartmann's procedure and 2 had a staged resection.3. Of 19 resected specimens, histologically 89.5% were adenocarcinoma which were diagnosed as well differentiated adenocarcinoma in 9 and as moderately differentiated adenocarcinoma in 8. Mucoid carcinoma and squamous cell carcinoma were recognized in one case respectively. The intestinal obstruction were correlated with serosal invasion. Lymphnode metastases was 57.9 % and histologically ly(+) 57.9% and v(+) 84.2%.4. Postoperative anastomosis leakage was found in 3 cases of the primary resection of the left colon, but cases of the staged resection and Hartmann's procedures were good results. The prognosis of 14 cases after curative operation was 1 months to 12 years 10 months and 5 years survival was 44.4%.