Primary colon resection or Hartmann’s procedure in malignant left-sided large bowel obstruction? The use of stents as a bridge to surgery

Prof. Dr. R.T. Grundmann

Aus World J Gastrointest Surg 2013; 5: 5-8

Abstract

There is still significant debate regarding the best surgical treatment for malignant left-sided large bowel obstruction. Primary resection and anastomosis offers the advantages of a definite procedure without need for further surgery. Its main disadvantages are related to the increased technical challenge and to the potential higher risk of anastomotic leakage that occurs in the emergency setting. Primary resection with end colostomy (Hartmann’s procedure) is considered the safer option. Tan et al compared in a systematic review and meta-analysis the use of self-expanding metallic stents (SEMS) as a bridge to surgery vs emergency surgery in the management of acute malignant left-sided large bowel obstruction.

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