- Meeting abstract
- Open Access
Laparoscopic diverting colostomy in the therapeutic management of large bowel obstructions in neoplastic elderly patients
© Prati et al; licensee BioMed Central Ltd. 2010
- Published: 19 May 2010
- Colorectal Cancer
- Hospital Stay
- Bowel Obstruction
- Laparoscopic Approach
- Large Bowel
Laparoscopic approach in patients with unresectable colorectal cancer avoids major laparotomy; we would like to estimate the feasibility, safety, and efficacy of the laparoscopic approach in elderly patients with obstruction of the large bowel.
Our personal experience includes 12 patients (8 men; 4 women); average age 75 years (range: 70-88). All patients had a history of bowel obstruction or of bleeding for sigmoid, rectal or anal cancer; the patients underwent laparoscopic stoma creation.
The patients were ASA II and III physical status. We used the strategy known as the “two-step treatment protocol” including: decompressive colostomy followed by neo adjuvant radio-chemio therapy and, in this case, by radical resection of the tumor with simultaneous stoma closure. Peri-operative and stomal complications, time to return to normal bowel function, and length of hospital stay were analysed.
All the patients underwent colostomy. No intra-operative or post-operative complications occurred, nor any conversion to laparotomy was required. A regular diet was tolerated 2 days after surgery with the return to normal bowel function. The length of post- operative hospital stay was about 5 days mainly owing to concomitant pre-existing co-morbidites.
In our experience laparoscopic colostomy is demonstrated to be a safe and feasible technique without morbidity and mortality in elderly patients. We saw a rapid return to normal bowel function with a short hospital stay. Therefore, at our institution, laparoscopic stoma creation is considerated the method of choice for fecal diversion and it represents an example of “fast-track" rehabilitation in elderly people too.
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This article is published under license to BioMed Central Ltd.