The Role of Intraoperative Colonoscopy in Patients with Left Side Colon Cancer Obstruction

Kim, Sung Mok; Kim, Jun Hwan; Jang, Byung Ik; Kim, Tae Nyeun; Chung, Moon Kwan; Kim, Jae Hwang

Abstract

BACKGROUND/AIMS
The aim of this study was to evaluate the role of an intraoperative colonoscopy for a single stage operation in patients with a left-side colon cancer obstruction.
METHODS
From September 1999 to August 2002, 62 patients (mean age=61+/-14 year old, M:F=30:32) underwent an intraoperative colonoscopy during a single stage operation for a left side colon cancer. Intraoperative colonic irrigation method and colonoscopy with NICI (new intraoperative colonic irrigator, MITech Co., Ltd, Seoul, Korea) were used.
RESULTS
The locations of the left-side colon cancers were the rectum in 33 (53.2%), sigmoid colon in 20 (32.3%), and descending colon in 9 (14.5%). Synchronous polyps were found in 31 patients (50%). Six patients (9.7%) had a synchronous colon cancer and 2 (3.2%) had a high grade dysplasia. Of these 62 patients, 11 (17.7%) required more extensive surgery than dictated by the primary tumor. Altered operative methods were a total colectomy in 2 patients, an extended resection in 8 patients, and a wedge resection in 1 patient. CONCULSIONS: An intraoperative colonoscopy in patients with a left-side colon cancer is a useful adjunct in diagnosing a synchronous lesions, which should allow a more appropriate surgical procedure.