OBSTRUCTIVE LEFT COLORECTAL CANCER

Decompression prior to a primary resection is desirable for the treatment of obstructive left colorectal cancer. The long intestinal tube method is inadequate to decompress the digestive tract. In our institute, a combined method using a decompression tube and a long intestinal tube has been adopted. A percutaneous transhepatic cholangioscopy (PTCS) tube is used as the decompression tube. This tube is useful for this method because of its appropriate degree of rigidity, and is inserted into an obstructive lesion through a guide wire during colonoscopy. A small PTCS tube is gradually exchanged for a large PTCS tube. Colon preparation with saline solution is performed using both tubes prior to surgery.This method was selected in three patients with rectal cancer and one with sigmoid colon cancer.Successful results were obtained in all patients. Our method is effective for preoperative management of patients with severe obstructive colorectal cancer.