Application of Ileus Tube in Treatment of Colonic Obstruction Caused by Colorectal Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Hongyan , DONG Qi , LIU Qingfeng , LI Shengxi , LIU Zhengrong , WANG Yanqing , FU Yongming

Department of General Surgery, People’s Hospital of Liaoning Province, Shenyang 110016, ChinaCorresponding Author： DONG Qi, Email： d.q001@163.com;

Corresponding author：

Keywords：

Ileus tube; Decompression; Colorectal carcinoma; Colonic obstruction; Onestage radical excision and anastomosis

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Objective 　To explore the clinical effects of ileus tube in treatment of colonic obstruction caused by colorectal carcinoma.
Methods 　Thirtytwo colorectal carcinoma patients with colonic obstruction admitted to our hospital from December 2005 to December 2008 were given onestage radical excision and anastomosis after transnasal or transanal placement of ileus tube for colonic decompression and drainage.
Results 　Combined placement of transnasal and transanal ileus tube was successfully carried out in 19 cases, while the other 13 cases were treated only with transnasal ileus tube. Abdominal pain and distention of all cases were relieved 12-36 h after tube placement, while those of 26 cases disappeared 48-96 h later. Compared with before tube placement, abdominal circumferences of all cases were significantly reduced after tube placement, the mean reduction rate was (81.3±19.6)% vs. 100% (t=3.586, P=0.02). All cases were successfully treated by onestage radical excision and anastomosis 5-7 d after placement, and no serious complications such as peritoneal infection, anastomotic leakage etc. were found.
Conclusion 　Preoperative intubation of ileus tube can enhance the therapeutic effects of onestage radical excision and anastomosis in patients with colorectal carcinoma combined with colonic obstruction.

Citation： WANG Hongyan,DONG Qi,LIU Qingfeng,LI Shengxi,LIU Zhengrong,WANG Yanqing,FU Yongming. Application of Ileus Tube in Treatment of Colonic Obstruction Caused by Colorectal Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(9): 698-701. doi: Copy

1.	Baccari P, Bisagni P, Crippa S, et al. Operative and longterm results after onestage surgery for obstructing colonic cancer [Ｊ]. Hepatogastroenterology, 2006; 53(71): 698701.
2.	Pavlidis TE, Marakis G, Ballas K, et al. Safety of bowel resection for colorectal surgical emergency in the elderly [Ｊ]. Colorectal Dis, 2006; 8(8): 657662.
3.	Morino M, Bertello A, Garbarini A, et al. Malignant colonic obstruction managed by endoscopic stent decompression followed by laparoscopic resections [Ｊ]. Surg Endosc, 2002; 16(10): 14831487.
4.	Edino ST, Mohammed AZ, Anumah M. Intraoperative colonic lavage in emergency surgical treatment of leftsided large bowel lesions [Ｊ]. Trop Doct, 2005; 35(1): 3738.
5.	Lim JF, Tang CL, SeowChoen F, et al. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed leftsided colorectal cancer [Ｊ]. Dis Colon Rectum, 2005; 48(2): 205209.
6.	Baik SH, Kim NK, Cho HW, et al. Clinical outcomes of metallic stent insertion for obstructive colorectal cancer [Ｊ]. Hepatogastroenterology, 2006; 53(68): 183187.
7.	Singh H, Latosinsky S, Spiegel BM, et al. The costeffectiveness of colonic stenting as a bridge to curative surgery in patients with acute leftsided malignant colonic obstruction: a Canadian perspective [Ｊ]. Can J Gastroenterol, 2006; 20(12): 779785.
8.	Ng KC, Law WL, Lee YM, et al. Selfexpanding metallic stent as a bridge to surgery versus emergency resection for obstructing leftsided colorectal cancer: a casematched study [Ｊ]. J Gastrointest Surg, 2006; 10(6): 798803.
9.	Nozoe T, Matsumata T. Usefulness of preoperative colonic lavage using transanal ileus tube for obstructing carcinoma of left colon: device to perform onestage operation safely [Ｊ]. J Clin Gastroenterol, 2000; 31(2): 156158.
10.	许剑民, 钟芸诗, 徐美东, 等. 经肛型肠梗阻减压导管在急性低位结直肠梗阻中的应用 [Ｊ]. 中华胃肠外科杂志, 2006; 9(4): 308310.
11.	Fischer A, Schrag HJ, Goos M, et al. Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases [Ｊ]. Surg Endosc, 2008; 22(3): 683688.
12.	Xu M, Zhong Y, Yao L, et al. Endoscopic decompression using a transanal drainage tube for acute obstruction of the rectum and left colon as a bridge to curative surgery [Ｊ]. Colorectal Dis, 2009; 11(4): 405409.
13.	汪建平. 重视结直肠癌外科手术患者术后生存质量的提高 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 625628.
14.	Nemes R, Vasile I, Curca T, et al. Acute bowel obstructionthe main complication of colorectal cancer. Therapeutical options [Ｊ]. Rom J Gastroenterol, 2004; 13(2): 109112.
15.	Hsu TC. Comparison of onestage resection and anastomosis of acute complete obstruction of left and right colon [Ｊ]. Am J Surg, 2005; 189(4): 384387.
16.	孙备, 许军, 周尊强, 等. 左半结肠癌并发急性肠梗阻一期切除吻合的合理性与评价 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1): 103104.
17.	张锡友, 陈轩. 老年急性结肠癌性肠梗阻的诊断及外科治疗体会 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 851852.
18.	汪志明, 李宁. 肠梗阻的减压治疗 [Ｊ]. 中国实用外科杂志, 2008; 28(9): 700702.
19.	Gullino D, Giordano O, Ghione S, et al. The singlestage surgery of colorectal neoplastic occlusion. The experience of 133 cases [Ｊ]. Minerva Chir, 1999; 54(12): 3747.
20.	Horiuchi A, Maeyama H, Ochi Y, et al. Usefulness of Dennis Colorectal Tube in endoscopic decompression of acute, malignant colonic obstruction [Ｊ]. Gastrointest Endosc, 2001; 54(2): 229232.
21.	Horiuchi A, Nakayama Y, Tanaka N, et al. Acute colorectal obstruction treated by means of transanal drainage tube: effectiveness before surgery and stenting [Ｊ]. Am J Gastroenterol, 2005; 100(12): 27652770.
22.	Gowen GF. Long tube decompression is successful in 90% of patients with adhesive small bowel obstruction [Ｊ]. Am J Surg, 2003; 185(6): 512515.
23.	Gowen GF. Rapid resolution of smallbowel obstruction with the long tube, endoscopically advanced into the jejunum [Ｊ]. Am J Surg, 2007; 193(2): 184189.
24.	姚宏伟, 傅卫, 袁炯, 等. 经肛肠梗阻导管治疗急性左半结肠恶性梗阻性疾病的临床研究 [Ｊ]. 中国微创外科杂志, 2006; 6(12): 941943.
25.	Yokohata K, Sumiyoshi K, Hirakawa K. Merits and faults of transanal ileus tube for obstructing colorectal cancer [Ｊ]. Asian J Surg, 2006; 29(3): 125127.

1. Baccari P, Bisagni P, Crippa S, et al. Operative and longterm results after onestage surgery for obstructing colonic cancer [Ｊ]. Hepatogastroenterology, 2006; 53(71): 698701.
2. Pavlidis TE, Marakis G, Ballas K, et al. Safety of bowel resection for colorectal surgical emergency in the elderly [Ｊ]. Colorectal Dis, 2006; 8(8): 657662.
3. Morino M, Bertello A, Garbarini A, et al. Malignant colonic obstruction managed by endoscopic stent decompression followed by laparoscopic resections [Ｊ]. Surg Endosc, 2002; 16(10): 14831487.
4. Edino ST, Mohammed AZ, Anumah M. Intraoperative colonic lavage in emergency surgical treatment of leftsided large bowel lesions [Ｊ]. Trop Doct, 2005; 35(1): 3738.
5. Lim JF, Tang CL, SeowChoen F, et al. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed leftsided colorectal cancer [Ｊ]. Dis Colon Rectum, 2005; 48(2): 205209.
6. Baik SH, Kim NK, Cho HW, et al. Clinical outcomes of metallic stent insertion for obstructive colorectal cancer [Ｊ]. Hepatogastroenterology, 2006; 53(68): 183187.
7. Singh H, Latosinsky S, Spiegel BM, et al. The costeffectiveness of colonic stenting as a bridge to curative surgery in patients with acute leftsided malignant colonic obstruction: a Canadian perspective [Ｊ]. Can J Gastroenterol, 2006; 20(12): 779785.
8. Ng KC, Law WL, Lee YM, et al. Selfexpanding metallic stent as a bridge to surgery versus emergency resection for obstructing leftsided colorectal cancer: a casematched study [Ｊ]. J Gastrointest Surg, 2006; 10(6): 798803.
9. Nozoe T, Matsumata T. Usefulness of preoperative colonic lavage using transanal ileus tube for obstructing carcinoma of left colon: device to perform onestage operation safely [Ｊ]. J Clin Gastroenterol, 2000; 31(2): 156158.
10. 许剑民, 钟芸诗, 徐美东, 等. 经肛型肠梗阻减压导管在急性低位结直肠梗阻中的应用 [Ｊ]. 中华胃肠外科杂志, 2006; 9(4): 308310.
11. Fischer A, Schrag HJ, Goos M, et al. Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases [Ｊ]. Surg Endosc, 2008; 22(3): 683688.
12. Xu M, Zhong Y, Yao L, et al. Endoscopic decompression using a transanal drainage tube for acute obstruction of the rectum and left colon as a bridge to curative surgery [Ｊ]. Colorectal Dis, 2009; 11(4): 405409.
13. 汪建平. 重视结直肠癌外科手术患者术后生存质量的提高 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 625628.
14. Nemes R, Vasile I, Curca T, et al. Acute bowel obstructionthe main complication of colorectal cancer. Therapeutical options [Ｊ]. Rom J Gastroenterol, 2004; 13(2): 109112.
15. Hsu TC. Comparison of onestage resection and anastomosis of acute complete obstruction of left and right colon [Ｊ]. Am J Surg, 2005; 189(4): 384387.
16. 孙备, 许军, 周尊强, 等. 左半结肠癌并发急性肠梗阻一期切除吻合的合理性与评价 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1): 103104.
17. 张锡友, 陈轩. 老年急性结肠癌性肠梗阻的诊断及外科治疗体会 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 851852.
18. 汪志明, 李宁. 肠梗阻的减压治疗 [Ｊ]. 中国实用外科杂志, 2008; 28(9): 700702.
19. Gullino D, Giordano O, Ghione S, et al. The singlestage surgery of colorectal neoplastic occlusion. The experience of 133 cases [Ｊ]. Minerva Chir, 1999; 54(12): 3747.
20. Horiuchi A, Maeyama H, Ochi Y, et al. Usefulness of Dennis Colorectal Tube in endoscopic decompression of acute, malignant colonic obstruction [Ｊ]. Gastrointest Endosc, 2001; 54(2): 229232.
21. Horiuchi A, Nakayama Y, Tanaka N, et al. Acute colorectal obstruction treated by means of transanal drainage tube: effectiveness before surgery and stenting [Ｊ]. Am J Gastroenterol, 2005; 100(12): 27652770.
22. Gowen GF. Long tube decompression is successful in 90% of patients with adhesive small bowel obstruction [Ｊ]. Am J Surg, 2003; 185(6): 512515.
23. Gowen GF. Rapid resolution of smallbowel obstruction with the long tube, endoscopically advanced into the jejunum [Ｊ]. Am J Surg, 2007; 193(2): 184189.
24. 姚宏伟, 傅卫, 袁炯, 等. 经肛肠梗阻导管治疗急性左半结肠恶性梗阻性疾病的临床研究 [Ｊ]. 中国微创外科杂志, 2006; 6(12): 941943.
25. Yokohata K, Sumiyoshi K, Hirakawa K. Merits and faults of transanal ileus tube for obstructing colorectal cancer [Ｊ]. Asian J Surg, 2006; 29(3): 125127.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Ileus Tube in Treatment of Colonic Obstruction Caused by Colorectal Carcinoma

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