The Role of Intraoperative Colonoscopy in Patients with Left Side Colon Cancer Obstruction

Background/Aims: The aim of this study was to evaluate the role of an intraoperative colonoscopy for a single stage operation in patients with a left-side colon cancer obstruction. Met hods: From September 1999 to August 2002, 62 patients (mean age=6114 year old, M : F=30 : 32) underwent an intraoperative colonoscopy during a single stage operation for a left side colon cancer. Intraoperative colonic irrigation method and colonoscopy with NICI (new intraoperative colonic irrigator, MITech Co., Ltd, Seoul, Korea) were used. Results: The locations of the left-side colon cancers were the rectum in 33 (53.2%), sigmoid colon in 20(32.3%), and descending colon in 9 (14.5%). Synchronous polyps were found in 31 patients (50%). Six patients (9.7%) had a synchronous colon cancer and 2 (3.2%) had a high grade dysplasia. Of these 62 patients, 11 (17.7%) required more extensive surgery than dictated by the primary tumor. Altered operative methods were a total colectomy in 2patients, an extended resection in 8 patients, and a wedge resection in 1 patient. Conclusions: An intraoperative colonoscopy in patients with a left-side colon cancer is a useful adjunct in diagnosing a synchronous lesions, which should allow a more appropriate surgical procedure.