Investigation of Usefulness of and Complications with Transanal Decompression using a Drainage Tube for Acute Malignant Colonic Obstruction

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 25; no. 3; pp. 499 - 504
• Main Authors: Tanaka, Toyohiko, Furukawa, Akira, Nitta, Norihisa, Yamasaki, Michio, Takahashi, Masashi, Murata, Kiyoshi, Imoto, Katsuji, Sakamoto, Tsutomu
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2005
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.25.499

Acute malignant colorectal obstruction is an oncologic emergency. It is a common complication of advanced colorectal carcinoma that necessitates an emergency operation. However, because of colonic distension, fecal loading, and the poor general condition of the patient caused by colorectal obstructions, postoperative morbidity and mortality rates are very high. We developed a drainage tube for transanal decompression of an obstructed colon. In the past 5 years, 69 patients with acute colorectal obstruction secondary to carcinoma were treated by means of intubation with this drainage tube. Placement of the drainage tube was successful in 63 (91.3%) of 69 patients. In the 6 cases of unsuccessful placement of the drainage tube, an emergency colostomy was performed. In the 63 cases of successful placement of the tube, bowel perforation occurred in 5 (8%) cases caused because of pressure of the tip of the tube. In all 5 cases, emergency surgery was performed without severe complications. The remaining 58 cases had elective single-stage surgery without any severe complications such as anastomotic leakage and postanastomotic stenosis. Decompression using a transanal drainage tube is useful for avoiding an emergency operation or allowing a safe one-stage operation to be performed.