The management of malignant large bowel obstruction: ACPGBI position statement

Colorectal Disease

Volumn 9, Issue SUPPL.4, 2007, Pages 1-17

  Finan, Paul J ^a   Campbell, S ^b   Verma, R ^c   Macfie, J ^d   Gatt, M ^d   Parker, M C ^e   Bhardwaj, R ^e   Hall, N R ^f  

^a LEEDS GENERAL INFIRMARY   (United Kingdom)

^b LEICESTER ROYAL INFIRMARY   (United Kingdom)

^c LEICESTER GENERAL HOSPITAL   (United Kingdom)

^d SCARBOROUGH HOSPITAL   (United Kingdom)

^e DARENT VALLEY HOSPITAL   (United Kingdom)

^f ADDENBROOKE S HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ATRACURIUM; BUPIVACAINE; CONTRAST MEDIUM; FENTANYL; IBUPROFEN; MORPHINE; NITROGEN; OLIGOFRUCTOSE; OXYGEN; PARACETAMOL; PREBIOTIC AGENT; PROBIOTIC AGENT; PROPOFOL; SEVOFLURANE; TREVIS; UNCLASSIFIED DRUG;

ABDOMINAL RADIOGRAPHY; ANASTOMOSIS LEAKAGE; ARTICLE; CANCER PALLIATIVE THERAPY; CLINICAL TRIAL; COCHRANE LIBRARY; COLON ANASTOMOSIS; COLON BIOPSY; COLON LAVAGE; COLON OBSTRUCTION; COLON PERFORATION; COLON RESECTION; COLON SURGERY; COLONOSCOPY; COLORECTAL CANCER; COMPUTER ASSISTED TOMOGRAPHY; CONTINUOUS INFUSION; CONTRAST ENHANCEMENT; COST EFFECTIVENESS ANALYSIS; CRYOSURGERY; DIAGNOSTIC ACCURACY; EMBASE; EVIDENCE BASED MEDICINE; GENERAL ANESTHESIA; HEALTH CARE COST; HUMAN; INFORMATION RETRIEVAL; INTERMETHOD COMPARISON; INTESTINE INFECTION; LASER SURGERY; LOW LEVEL LASER THERAPY; MEDLINE; METAL IMPLANTATION; PEROPERATIVE CARE; POSTOPERATIVE CARE; POSTOPERATIVE PAIN; PREDICTION; PREOPERATIVE CARE; PRIORITY JOURNAL; SENSITIVITY AND SPECIFICITY; STENT; SURGICAL INFECTION; SURGICAL MORTALITY; TREATMENT OUTCOME;

COLECTOMY; COLORECTAL NEOPLASMS; COMBINED MODALITY THERAPY; EMERGENCIES; GREAT BRITAIN; HUMANS; INTESTINAL OBSTRUCTION; IRELAND; PALLIATIVE CARE; PERIOPERATIVE CARE; SOCIETIES, MEDICAL; STENTS;

EID: 34548760822     PISSN: 14628910     EISSN: 14631318     Source Type: Journal    
DOI: 10.1111/j.1463-1318.2007.01371.x     Document Type: Article

References (129)

1. Phillips RK, Hittinger R, Fry JS et al. Malignant large bowel obstruction. Br J Surg 1985; 72: 296-302.
2. Setti Carraro PG, Segala M, Cesana BM et al. Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage curative surgery. Dis Colon Rectum 2001; 44: 243-50.
3. Tekkis PP, Kinsman R, Thompson MR et al. The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg 2004; 240: 76-81.
4. Mella J, Biffin A, Radcliffe AG et al. Population-based audit of colorectal cancer management in two UK health regions. Colorectal Cancer Working Group, Royal College of Surgeons of England Clinical Epidemiology and Audit Unit. Br J Surg 1997; 84: 1731-6.
5. Eccles M, Mason J. How to develop cost-conscious guidelines. Health Technol Assess 2001; 5: 1-69.
6. Mann T. (1996) Clinical Guidelines: Using Clinical Guidelines to Improve Patient Care within the NHS. NHS Executive, London.
7. Chapman AH, McNamara M, Porter G. The acute contrast enema in suspected large bowel obstruction: Value and technique. Clin Radiol 1992; 46: 273-8.
8. Koruth NM, Koruth A, Matheson NA. The place of contrast enema in the management of large bowel obstruction. J R Coll Surg Edinb 1985; 30: 258-60.
9. Stewart J, Finan PJ, Courtney DF et al. Does a water soluble contrast enema assist in the management of acute large bowel obstruction: A prospective study of 117 cases. Br J Surg 1984; 71: 799-801.
10. Frager D, Rovno HD, Baer JW et al. Prospective evaluation of colonic obstruction with computed tomography. Abdom Imaging 1998; 23: 141-6.
11. Megibow AJ. Bowel obstruction. Evaluation with CT. Radiol Clin North Am 1994; 32: 861-70.
12. Taourel P, Kessler N, Lesnik A et al. Helical CT of large bowel obstruction. Abdom Imaging 2003; 28: 267-75.
13. Horton KM, Abrams RA, Fishman EK. Spiral CT of colon cancer: Imaging features and role in management. Radiographics 2000; 20: 419-30.
14. Sinha R, Verma R. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction. Clin Radiol 2005; 60: 1068-75.
15. Horiuchi A, Nakayama Y, Tanaka N et al. Acute colorectal obstruction treated by means of transanal drainage tube: Effectiveness before surgery and stenting. Am J Gastroenterol 2005; 100: 2765-70.
16. Khot UP, Lang AW, Murali K et al. Systematic review of the efficacy and safety of colorectal stents. Br J Surg 2002; 89: 1096-102.
17. Sebastian S, Johnston S, Geoghegan T et al. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol 2004; 99: 2051-7.
18. Saida Y, Sumiyama Y, Nagao J et al. Long-term prognosis of preoperative "bridge to surgery" expandable metallic stent insertion for obstructive colorectal cancer: Comparison with emergency operation. Dis Colon Rectum 2003; 46: S44-9.
19. Xinopoulos D, Dimitroulopoulos D, Theodosopoulos T et al. Stenting or stoma creation for patients with inoperable malignant colonic obstructions? Results of a study and cost-effectiveness analysis. Surg Endosc 2004; 18: 421-6.
20. Carne PW, Frye JN, Robertson GM et al. Stents or open operation for palliation of colorectal cancer: A retrospective, cohort study of perioperative outcome and long-term survival. Dis Colon Rectum 2004; 47: 1455-61.
21. Law WL, Choi HK, Chu KW. Comparison of stenting with emergency surgery as palliative treatment for obstructing primary left-sided colorectal cancer. Br J Surg 2003; 90: 1429-33.
22. Repici A, Reggio D, De Angelis C et al. Covered metal stents for management of inoperable malignant colorectal strictures. Gastrointest Endosc 2000; 52: 735-40.
23. Osman HS, Rashid HI, Sanathananthan N et al. The cost-effectiveness of self expanding metal stent in the management of malignant left-sided large bowel obstruction. Colorectal Dis 2000; 2: 233-7.
24. Targownik LE, Spiegel BM, Sack J et al. Colonic stent vs. emergency surgery for management of acute left-sided malignant colonic obstruction: A decision analysis. Gastrointest Endosc 2004; 60: 865-74.
25. Gevers AM, Macken E, Hiele M et al. Endoscopic laser therapy for palliation of patients with distal colorectal carcinoma: Analysis of factors influencing long-term outcome. Gastrointest Endosc 2000; 51: 580-5.
26. Meijer S, Rahusen FD, van der Plas LG. Palliative cryosurgery for rectal carcinoma. Int J Colorectal Dis 1999; 14: 177-80.
27. Smith JJ, Tekkis PP, Thompson MR et al. (2004) Report of the ACPGBI Bowel Cancer Study. ACPGBI, London. http://www.acpgbi.org.uk
28. Anderson AD, McNaught CE, MacFie J et al. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. Br J Surg 2003; 90: 1497-504.
29. Basse L, Raskov HH, Hjort Jakobsen D et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. Br J Surg 2002; 89: 446-53.
30. Delaney CP, Fazio VW, Senagore AJ et al. 'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery. Br J Surg 2001; 88: 1533-8.
31. Gatt M, Anderson AD, Reddy BS et al. Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection. Br J Surg 2005; 92: 1354-62.
32. Kehlet H, Wilmore DW. Fast-track surgery. Br J Surg 2005; 92: 3-4.
33. Gatt M, Macfie J. Fast-track surgery (Br J Surg 2005; 92: 3-4). Br J Surg 2005; 92: 494.
34. Disbrow EA, Bennett HL, Owings JT. Effect of preoperative suggestion on postoperative gastrointestinal motility. West J Med 1993; 158: 488-92.
35. Egbert LD, Battit GE, Welch CE et al. Reduction of postoperative pain by encouragement and instruction of patients. A study of doctor-patient rapport. N Engl J Med 1964; 270: 825-7.
36. Morrell G. Effect of structured preoperative teaching on anxiety levels of patients scheduled for cataract surgery. Insight 2001; 26: 4-9.
37. Hathaway D. Effect of preoperative instruction on postoperative outcomes: A meta-analysis. Nurs Res 1986; 35: 269-75.
38. Mangiante G, Colucci G, Gottin L et al. Effect of probiotic administration on colic anastomosis healing. Chir Ital 2001; 53: 39-44.
39. Rayes N, Seehofer D, Muller AR et al. Influence of probiotics and fibre on the incidence of bacterial infections following major abdominal surgery - results of a prospective trial. Zeitschr Gastroenterol 2002; 40: 869-76.
40. WHO Scientific Working Group on Monitoring and Management of Bacterial Resistance to Antimicrobial Agents (1994) Bacterial, Viral Diseases and Immunology. World Health Organisation, Geneva.
41. Beloosesky Y, Grinblat J, Weiss A et al. Electrolyte disorders following oral sodium phosphate administration for bowel cleansing in elderly patients. Arch Int Med 2003; 163: 803-8.
42. Guenaga KF, Matos D, Castro AA, et al. Mechanical bowel preparation for elective colorectal surgery. [update in Cochrane Database Syst Rev. 2005;(1): CD001544; PMID: 15674882]. Cochrane Database Syst Rev 2003; CD001544.
43. Holte K, Nielsen KG, Madsen JL et al. Physiologic effects of bowel preparation. Dis Colon Rectum 2004; 47: 1397-402.
44. Zmora O, Mahajna A, Bar-Zakai B et al. Colon and rectal surgery without mechanical bowel preparation: A randomized prospective trial. Ann Surg 2003; 237: 363-7.
45. Brady M, Kinn S, Stuart P. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev 2003; CD004423.
46. Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc 2002; 61: 329-36.
47. Akca O, Podolsky A, Eisenhuber E et al. Comparable postoperative pulmonary atelectasis in patients given 30% or 80% oxygen during and 2 hours after colon resection. Anesthesiology 1999; 91: 991-8.
48. Garcia-Botello SA, Garcia-Granero E, Lillo R et al. Randomized clinical trial to evaluate the effects of perioperative supplemental oxygen administration on the colorectal anastomosis. Br J Surg 2006; 93: 698-706.
49. Greif R, Akca O, Horn EP et al. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. Outcomes Research Group. N Engl J Med 2000; 342: 161-7.
50. Greif R, Laciny S, Rapf B et al. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology 1999; 91: 1246-52.
51. Ratnaraj J, Kabon B, Talcott MR et al. Supplemental oxygen and carbon dioxide each increase subcutaneous and intestinal intramural oxygenation. Anesth Analg 2004; 99: 207-11.
52. Baig MK, Wexner SD. Postoperative ileus: A review. Dis Colon Rectum 2004; 47: 516-26.
53. Kurz A, Sessler DI. Opioid-induced bowel dysfunction: Pathophysiology and potential new therapies. Drugs 2003; 63: 649-71.
54. Mythen MG. Postoperative gastrointestinal tract dysfunction. Anesth Analg 2005; 100: 196-204.
55. Oderda GM, Evans RS, Lloyd J et al. Cost of opiod-related adverse drug events in surgical patients. J Pain Symptom Manage 2003; 25: 276-83.
56. Holte K, Kehlet H. Epidural analgesia and risk of anastomotic leakage. Reg Anesth Pain Med 2001; 26: 111-7.
57. Jansen M, Fass J, Tittel A et al. Influence of postoperative epidural analgesia with bupivacaine on intestinal motility, transit time, and anastomotic healing. World J Surg 2002; 26: 303-6.
58. Donati D, Brown SR, Eu KW et al. Comparison between midline incision and limited right skin crease incision for right-sided colonic cancers. Tech Coloproctol 2002; 6: 1-4.
59. Grantcharov TP, Rosenberg J. Vertical compared with transverse incisions in abdominal surgery. Eur J Surg 2001; 167: 260-7.
60. Kam MH, Seow-Choen F, Peng XH et al. Minilaparotomy left iliac fossa skin crease incision vs. midline incision for left-sided colorectal cancer. Tech Coloproctol 2004; 8: 85-8.
61. Lindgren P, Nordgren S, Oresland T et al. Midline or transverse abdominal incision for right-sided colon cancer - a randomised trial. Colorectal Dis 2001; 3: 46-50.
62. Brown SR, Goodfellow PB. Transverse versus midline incisions for abdominal surgery. Cochrane Database Syst Rev 2005; CD005199. doi: 10.1002/14651858.CD005199.pub2.
63. Beier-Holgersen R, Boesby S. Effect of early postoperative enteral nutrition on postoperative infections. Ugeskr Laeger 1998; 160: 3223-6.
64. DiFronzo LA, Yamin N, Patel K et al. Benefits of early feeding and early hospital discharge in elderly patients undergoing open colon resection. J Am Coll Surg 2003; 197: 747-52.
65. Reissman P, Teoh TA, Cohen SM et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg 1995; 222: 73-7.
66. Merad F, Hay JM, Fingerhut A et al. Is prophylactic pelvic drainage useful after elective rectal or anal anastomosis? A multicenter controlled randomized trial. French Association for Surgical Research. Surgery 1999; 125: 529-35.
67. Cheatham ML, Chapman WC, Key SP et al. A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy. Ann Surg 1995; 221: 469-76.
68. Hoffmann S, Koller M, Plaul U et al. Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: A prospective, randomized trial comparing patients' tube-related inconvenience. Langenbecks Arch Surg 2001; 386: 402-9.
69. Carty NJ, Corder AP. Which surgeons avoid a stoma in treating left-sided colonic obstruction? Results of a postal questionnaire. Ann R Coll Surg Eng 1992; 74: 391-4.
70. Deen KI, Madoff RD, Goldberg SM et al. Surgical management of left colon obstruction: The University of Minnesota experience. J Am Coll Surg 1998; 187: 573-6.
71. Runkel NS, Hinz U, Lehnert T et al. Improved outcome after emergency surgery for cancer of the large intestine. Br J Surg 1998; 85: 1260-5.
72. Goyal A, Schein M. Current practices in left-sided colonic emergencies; a survery of US gastrointestinal surgeons. Dig Surg 2001; 18: 399-402.
73. Biondo S, Pares D, Frago R et al. Large bowel obstruction: Predictive factors for postoperative mortality. Dis Colon Rectum 2004; 47: 1889-97.
74. Villar JM, Martinez AP, Villegas MT et al. Surgical options for malignant left-sided colonic obstruction. Surg Today 2005; 35: 275-81.
75. Fielding LP, Stewart-Brown S, Blesovsky L. Large-bowel obstruction caused by cancer: A prospective study. Br Med J 1979; 2: 515-7.
76. Lee YM, Law WL, Chu KW et al. Emergency surgery for obstructing colorectal cancers: A comparison between right-sided and left-sided lesions. J Am Coll Surg 2001; 192: 719-25.
77. Hsu TC. Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg 2005; 189: 384-7.
78. Stamatakis J, Thompson M, Chave H et al. (2000) National Audit of Bowel Obstruction due to Colorectal Cancer April 1998 - March 1999: The Association of Coloproctology of Great Britain and Ireland. ACPGBI, London. http://www.acpgbi.org.uk
79. de Almeida AM, Gracias CW, dos Santos NM et al. Sugical management of acute, malignant obstruction of the left colon with colostomy. Acta Med Port 1991; 4: 257-62.
80. Gandrup P, Lund L, Balslev I. Surgical treatment of acute malignant large bowel obstruction. Eur J Surg 1992; 158: 427-30.
81. Sjodahl R, Franzen T, Nystrom PO. Primary versus staged resection for acute obstructing colorectal carcinoma. Br J Surg 1992; 79: 685-8.
82. Kressner U, Antonsson J, Ejerblad S et al. Intraoperative colonic lavage and primary anastomosis - an alternative to Hartmann procedure in emergency surgery of the left colon. Eur J Surg 1994; 160: 287-92.
83. Kronborg O. Acute obstruction from tumour in the left colon without spread. Int J Colorectal Dis 1995; 10: 1-5.
84. Maher M, Caldwell MPT, Waldron R et al. Staged resection or primary anastomosis for obstructing lesions to the left colon. Ir Med J 1996; 89: 138-9.
85. Zorcolo L, Covotta L, Carlomagno N et al. Safety of primary anastomosis in emergency colo-rectal surgery. Colorectal Dis 2003; 5: 262-9.
86. de Aguilar-Nascimento JE, Caporossi C, Nascimento M. Comparison between resection and primary anastomosis and staged resection in obstructing adenocarcinoma of the left colon. Arq Gastroenterol 2002; 39: 240-5.
87. Meyer F, Marusch F, Koch A et al. Emergency operation in carcinomas of the left colon: Value of Hartmann's procedure. Tech Coloproctol 2004; 8: s226-9.
88. Perrier G, Peillon C, Liberge N et al. Cecostomy is a useful surgical procedure: Study of 113 colonic obstructions caused by cancer. Dis Colon Rectum 2000; 43: 50-4.
89. Isbister WH, Prasad J. Hartmann's operation: A personal experience. Aust N Z J Surg 1995; 65: 98-100.
90. Kristiansen VB, Lausen IM, Frederiksen HJ et al. Hartmann's procedure in the treatment of acute obstructive left-sided colonic cancer. Ugeskr Laeger 1993; 155: 3816-8.
91. De Salvo GL, Gava C, Pucciarelli S et al. Curative surgery for obstruction from primary left colorectal carcinoma: Primary or staged resection? Cochrane Database Syst Rev 2004; CD002101.
92. The SCOTIA Study Group. Single-stage treatment for malignant left-sided colonic obstruction: A prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation. Br J Surg 1995; 82: 1622-7.
93. Nyam DCNK, Leong AFPK, Ho YH et al. Comparison between segmental left and extended right colectomies for obstructing left-sided colonic carcinomas. Dis Colon Rectum 1996; 39: 1000-3.
94. Torralba JA, Robles R, Parilla P et al. Subtotal colectomy vs intraoperative colonic irrigation in the management of obstructed left colon carcinoma. Dis Colon Rectum 1998; 41: 18-22.
95. Morgan WP, Jenkins N, Lewis P et al. Management of obstructing carcinoma of the left colon by extended right hemicolectomy. Am J Surg 1985; 149: 327-9.
96. Slors JFM, Taat CW, Mollonga ET et al. One-stage colectomy and ileorectal anastomosis for complete left-sided obstruction of the colon. Neth J Surg 1989; 41: 1-4.
97. Wilson RG, Gollock JM. Obstructing carcinoma of the left colon managed by subtotal colectomy. J R Coll Surg Edinb 1989; 34: 25-6.
98. Stephenson BM, Shandall A, Farouk R et al. Malignant left-sided large bowel obstruction managed by subtotal/total colectomy. Br J Surg 1990; 77: 1098-102.
99. Brief DK, Brener BJ, Goldenkranz R et al. Defining the role of subtotal colectomy in the treatment of carcinoma of the colon. Ann Surg 1991; 213: 248-52.
100. Arnaud JP, Bergamaschi R. Emergency subtotal/total colectomy with anastomosis for acutely obstructed carcinoma of the left colon. Dis Colon Rectum 1994; 37: 685-8.
101. Reemst PHR, Kuijpers HC, Wobbes T. Management of left-sided colonic obstruction by subtotal colectomy and ileocolic anastomosis. Eur J Surg 1998; 164: 537-40.
102. Perez-Diaz D, Turegano-Fuentes F, Calvo-Serrano M et al. Emergency subtotal colectomy as treatment of choice in obstructing carcinomas of the left colon. Colorectal Dis 1999; 1: 15-8.
103. Pollock AV, Playforth MJ, Evans M. Peroperative lavage of the obstructed left colon to allow safe primary anastomosis. Dis Colon Rectum 1987; 30: 171-3.
104. Konishi F, Muto T, Kanazawa K et al. Intraoperative irrigation and primary resection for obstructing lesions of the left colon. Int J Colorectal Dis 1988; 3: 204-6.
105. Danne P. Intra-operative colonic lavage: Safe single-stage, left colorectal resections. Aust N Z J Surg 1991; 61: 59-65.
106. Tan SG, Nambiar R, Rauff A et al. Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg 1991; 126: 748-51.
107. Allen-Mersh TG. Should primary anastomosis and on-table colonic lavage be standard treatment for left colon emergencies? Ann R Coll Surg Engl 1993; 75: 195-8.
108. Lau PWK, Lo C-Y, Law WL. The role of one-stage surgery in acute left-sided colonic obstruction. Am J Surg 1995; 169: 406-9.
109. Biondo S, Jaurrieta E, Jorba R et al. Intraoperative colonic lavage and primary anastomosis in peritonitis and obstruction. Br J Surg 1997; 84: 222-5.
110. Forloni B, Reduzzi R, Paludetti A et al. Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction. Dis Colon Rectum 1998; 41: 23-7.
111. Chiappa A, Zbar A, Biella F et al. One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer. Am Surg 2000; 66: 619-22.
112. Dorudi S, Wilson NM, Heddle RM. Primary restorative colectomy in malignant left-sided large bowel obstruction. Ann R Coll Surg Engl 1990; 72: 393-5.
113. Naraynsingh V, Rampaul R, Maharaj D et al. Prospective study of primary anastomosis without colonic lavage for patients with an obstructed left colon. Br J Surg 1999; 86: 1341-3.
114. Patriti A, Contine A, Carbone E et al. One-stage resection without colonic lavage in emergency surgery of the left colon. Colorectal Dis 2005; 7: 332-8.
115. Nyam DCNK, Seow Choen F, Leong AFPK et al. Colonic decompression without on-table irrigation for obstructing left-sided colorectal tumours. Br J Surg 1996; 83: 786-7.
116. Lim JF, Tang C-L, Seow Choen F et al. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed left-sided colorectal cancer. Dis Colon Rectum 2005; 48: 205-9.
117. Klatt GR, Martin WH, Gillespie JT. Subtotal colectomy with primary anastomosis without diversion in the treatment of obstructing carcinoma of the left colon. Am J Surg 1981; 141: 577-8.
118. Schrock TR, Deveney CW, Dunphy JE. Factors contributing to leakage of colonic anastomoses. Ann Surg 1973; 177: 513-8.
119. Smith SR, Connolly JC, Gilmore OJ. The effect of faecal loading on colonic anastomotic healing. Br J Surg 1983; 70: 49-50.
120. Muir EG. Safety incolonic resection. J R Soc Med 1968; 61: 401-8.
121. Dudley HAF, Radcliffe AG, McGeehan D. Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg 1980; 67: 80-1.
122. Wille-Jorgensen P, Guenaga KF, Matos D et al. Pre-operative mechanical bowel cleansing or not? an updated meta-analysis. Colorectal Dis 2005; 7: 304-10.
123. Fielding LP, Phillips RK, Hittinger R. Factors influencing mortality after curative resection for large bowel cancer in elderly patients. Lancet 1989; 1: 595-7.
124. Poon RTP, Law WL, Chu KW et al. Emergency resection and primary anastomosis for left-sided obstructing colorectal carcinoma in the elderly. Br J Surg 1998; 85: 1539-42.
125. Runkel NS, Schlag P, Schwarz V et al. Outcome after emergency surgery for cancer of the large intestine. Br J Surg 1991; 78: 183-8.
126. Anderson JH, Hole D, McArdle CS. Elective versus emergency surgery for patients with colorectal cancer. Br J Surg 1992; 79: 706-9.
127. Chester J, Britton D. Elective and emergency surgery for colorectal cancer in a district general hospital: Impact of surgical training on patient survival. Ann R Coll Surg Engl 1989; 71: 370-4.
128. Darby CR, Berry AR, Mortensen N. Management variability in surgery for colorectal emergencies. Br J Surg 1992; 79: 206-10.
129. Poon JT, Chan B, Law WL. Evaluation of P-POSSUM in surgery for obstructing colorectal cancer and correlation of the predicted mortality with different surgical options. Dis Colon Rectum 2005; 48: 493-8.