Surgical management of @entity292 in XXXX : role of preoperative colonoscopy.

@entity1 @entity292 @entity30
PURPOSE: Surgical treatment of @entity292 in @entity30 remains controversial and can be radical (resection of both segments) or conservative (ileal resection with suture or wedge resection of the sigmoid). At our institution, the sigmoid defect is sutured if the sigmoid is not affected by primary @entity30 or by important stricture; otherwise, the sigmoid is resected. We reviewed our experience to evaluate our results with this procedure. METHODS: Thirty @entity1 with @entity292 underwent operation. Among them, 15 had a preoperative colonoscopy, whereas others had no endoscopic work-up. In nine @entity1 , the sigmoid was thought to be affected by @entity30 (n = 7) or stricture (n = 2) and was resected. In 21 @entity1 , the sigmoid was thought to be affected by proximity, and a simple suture (n = 15) or wedge resection (n = 6) was performed. Eleven @entity1 had a temporary stoma (37 percent). One had coloprotectomy. RESULTS: One @entity1 died postoperatively. One @entity1 had postoperative sigmoidocutaneous @entity292 after conservative treatment. Histology of the sigmoid specimen showed @entity30 in 8 @entity1 (27 percent), including 5 of 9 resected specimens, and 3 of 21 conservative procedures. All @entity1 with @entity30 did not have preoperative colonoscopy. Nine of 11 stomas were closed in a median delay of four months. With a median delay of nine years, four @entity1 have again undergone surgery for recurrent @entity30 , all of whom underwent surgery initially without preoperative colonoscopy. CONCLUSION: Preoperative endoscopic assessment of the colon is a reliable guide to use when choosing between sigmoid resection or a conservative approach and can result in reduced morbidity and improved long-term results.
