Effectiveness of a long intestinal tube in a one-stage operation for obstructing carcinoma of the left colon.

Five consecutive patients with obstructing carcinoma of the left colon were successfully managed by long intestinal tube decompression. The tube was introduced pernasal into the duodenum on the day of admission. The tube advanced spontaneously into the ascending colon with marked abdominal decompression within several days. Thereafter, preoperative colonic irrigation through this tube was performed. In three of five patients, segmental colectomy was accomplished without intraoperative cleansing. In two patients, fecal residue was removed by intraoperative colonic irrigation using the long tube. Proximal colostomy was avoided in all patients. This treatment protocol enabled: 1) both preoperative and intraoperative colonic irrigation and cleansing; 2) elective surgery instead of emergency; 3) safe one-stage operation with secure colonic anastomosis; and 4) segmental resection rather than subtotal resection of the colon.