Il trattamento chirurgico delle occlusioni neoplastiche colo-rettali

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COD: 027-032 Categorie: ,

Franco Stagnitti, Marcello De Pascalis, Francesco Priore, Sergio Corelli, Francesco Schillaci, Pier Federico Salvi, Pietro Gammardella

Ann. Ital. Chir., 2006; 77: 27-31

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The emergency treatment for neoplastic occlusions of rectum still needs debugging. While we finds perfect accord in to
directly treat with a right emicolectomy (more or less widened) the tumours from cecum to the first portion of the right
colon, not the indications are likewise shared in presence of neoplastic stenosis of sigma-rectum. The treatment of urgency
of these tumours is lent to so many variable and the tendencies too are constantly in evolution in relationship to the
improvement of the technologies and the surgical devices. We have to chose from the two-three times intervention (now
with less succession), or the total or subtotal colectomy otherwise the most used left emicolectomy and anterior resection
for sigmoid colon.
Presenting our historical cases of 31 years of activity (Institute of Surgical Emergency Department – University “La
Sapienza” of Rome), 564 neoplastic occlusions of the colon (75.7% sigma-rectum), the Authors describe their attitude
both of approach and of surgical therapy in urgency that has brought them to practise in the 65,6% of the cases the
anterior resection without protection colostomy, with extraperitoneal anastomosis and reconstitution of the pelvic peritoneum,
in all the stenosis under descendant – sigma. In the last period it is frequent more and more the tendency to the
positioning of a stent on the neoplastic stenosis: this treatment allows us to overcome the emergency to operate then under
fitter conditions.

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