Studies of clinicopathological Features and surgical Management on Obstructing Carcinoma of the Large Bowel

Katsuya Kuroda, Yoshiki Horita, Michio Kato, Masayoshi Sakane, Satoru Okumoto, Toshimasa Yamaguchi, Yoichi Saitoh

First Department of Surgery, Kobe University School of Medicine

Clinicopathological features in 37 patients with obstructing carcinoma of the large bowel were compared with those in 487 patients with non-obstructing cases, and the timing of surgery and the surgical procedure for obstructing carcinoma of the large bowel were studied. Many patients with obstructing carcinoma were over 70 years of age, and the incidence was high in the transverse colon, particularly the left transverse colon. Marcoscopically, the incidence of type 3 cancer and of the circumferential type was higher than in the nonobstructing cases. Histologically, the incidence of poorly differentiated adenocarcinoma, of a lesion showing depth of invasion of ss or more and of a lesion of v (+) was higher than in non-obstructing cases. Thus, there were more cases of progressive cancer among the patients with obstruction. The rate of curative resection were low in the patients with obstruction, whereas the accumulated 5-year survival rate after curative resection for patients with stage III or IV cancer was not different from that for the patients without obstruction in the same stage. This finding suggests that as radical surgical treatment as possible should be selected for patients with obstruction. In the patients in whom primary anastomosis was possible. dilatation of the intestinal tract on the oral side was 2 times or less than that on the anal side. Therefore, we believe it is possible for the intestinal tract to be anastomosed if the diameter of the intestinal tract on the oral side is 2 timesor less than on the anal side.

Key words
clinicopathological features of obstructing carcinoma of the large bowel, surgical management of obstructing carcinoma of the large bowel

Reprint requests
Katsuya Kuroda First Department of Surgery, Kobe University of Medicine
7-5-2 Kusunoki-chou, Chuo-ku, Kobe, 650 JAPAN

Accepted
July 7, 1993

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