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n CME : Your SA Journal of CPD - Advances in the treatment of malignant large-bowel obstruction : main article

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Abstract

  1. Malignant colonic obstruction carries a high mortality rate.
  2. The priorities of treatment are fluid resuscitation and decompression of the upstream bowel.
  3. Right-sided obstructing lesions are usually treated by a right hemicolectomy and primary anastomosis.
  4. Colonic stenting offers a safe, minimally invasive approach to decompressing the obstructed colon.
  5. Colonic stenting may be done as definitive palliation, or as a 'bridge to surgery'.
  6. Several operative strategies exist for left-sided colonic obstruction, and the choice of procedure depends on the general condition of the patient, and the surgeon's experience.
  7. In an unstable patient, or when the surgeon is inexperienced in major colonic surgery, a defunctioning colostomy is a safe option for emergency decompression of the bowel.

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/content/m_cme/25/7/EJC63347
2007-07-01
2016-12-08
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