[Obstructive left colonic cancer. Retrospective analysis of the therapeutic attitude in a series of 40 recent cases].

In a series of 40 cancers involving the descending and sigmoid colon and producing true acute obstruction, the following were performed: 16 colostomies of first intention (including 11 palliative); 14 resections with colostomy (Hartmann type); 9 resection-anastomoses (including 3 protected); 1 attempt at laser treatment for non consent to surgery. Only 22 patients were theoretically suitable for anastomosis (18 contraindications due to invasive cancer or peritonitis); this was in fact carried out in 9 cases. Thus, if single stage surgery represents the ideal, it cannot be systematically applied; on the other hand, tumor resection can often be performed. It would seem that the use of per-operative colonic lavage can increase the percentage of single stage surgery, though there will always be a place for Hartmann or Bouilly-Volkmann type procedures, future reestablishment of continuity being facilitated by the use of surgical staples (EEA type).