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DOI: 10.48087/BJMS.2026.130403
Authors: Zoheir BOUCHAIR1, Khalida CHARAOUI2, Amira BELHAMRA1, Mohamed BENTAMENE1, Imene NEHAL1, Rabeh KHENNAOUI1, Ali BELMIR1
Affiliations: 1- Chirurgie générale au urgences chirurgicales CHU de Constantine – Algérie. 2- Service d’infectiologie, CHU de Constantine – Algérie.
Abstract
Introduction: Colon cancer is frequently diagnosed at the stage of complications, accounting for 60% to 70% of cases. In the absence of a consensus regarding the emergency management of left-sided colon cancer, the decision to restore bowel continuity is guided by the local condition of the colon and the patient’s overall health status; however, it often ultimately rests with the surgeon, depending on their availability, experience, workload, and on-call circumstances. Materials and Methods: This prospective comparative study evaluated two surgical techniques — single-stage surgery and two-stage surgery — over a 4-year period. A total of 124 patients admitted to the surgical emergency department for acute bowel obstruction secondary to a colonic tumor were included. The two approaches were assessed based on the following criteria: feasibility and short- to medium-term outcomes; morbidity and mortality; length of hospital stay; and short- to medium-term overall survival. Results: Single-stage surgery was performed in 62.1% of patients. This included 56 resections with anastomosis — 16 with intraoperative colonic lavage and 40 without — as well as one subtotal colectomy. No significant differences were observed in the quality of resection, length of hospital stay, or pTNM staging between the two groups. However, patients managed with single-stage surgery experienced a lower rate of postoperative complications. Conclusion: Acute bowel obstruction due to left-sided colon cancer remains a common surgical emergency, and its operative management lacks true standardization, leaving considerable discretion to the treating surgeon. A growing body of evidence comparing single-stage versus two-stage approaches favors the former, underscoring the need for further well-designed studies to establish a clear and widely accepted management consensus.
Keywords: Colon, obstruction, surgical treatment, therapeutic choice.