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[Surgical therapy of tumor-induced ileus of the large intestine].

The principle of staged surgical approach to tumour-dependent colonic ileus is no longer justified in all situations. One single right-side hemicolectomy has proved to be superior to the staged approach in cases of colonic ileus on the right to transverse centre. Surgical treatment was applied to 22 patients with right colonic ileus, between 1983 and 1986. Seven of them died after surgery, including three of eight who had undergone palliative operations and four of 14 who had undergone radical surgery in one single session. Transversal colostomy as a first step of a staged approach has proved to be successful on patients with left colonic ileus, from transverse centre. It was found to be just as promising as one single approach. One single approach required intestinal evacuation, using a specific aseptic technique. Incontinence resection (Hartmann's operation) has proved to be an effective method. The majority of 31 patients with left colonic ileus underwent staged surgery. Hartmann's operation was performed on seven of them, and external defecation without resection was applied to 24. Twelve of them died after the first operation, including two after Hartmann's operation and ten of 23 after external defecation without tumour removal.