Abstract
Colorectal cancer, the most common cause of mechanical obstruction, has a higher incidence in the obese patient. Before surgery the obese patient needs a careful evaluation of the cardiac risk, cardiovascular and metabolic diseases. Electrolyte abnormalities should be corrected, and prophylaxis for deep vein thrombosis should be implemented.
In the obese patient the surgical treatment, one-stage or two-stage operation, depends on the location of the obstruction, condition of the proximal colon and comorbidities, as in the normal patient. It is important, however, to have the patient in a proper position on the operating room table especially if a laparoscopic procedure is planned. Another challenge is the creation of the ostomies.
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References
Masoomi H, Kang CY, Chaudhry O, et al. Predictive factors of early bowel obstruction in colon and rectal surgery: data from the Nationwide Inpatient Sample. J Am Coll Surg. 2012;214:831–7.
Javors BR, Baker SR, Miller J. The northern exposure sign: a newly described finding in sigmoid volvulus. AJR Am J Roentgenol. 1999;173:571–4.
Saavedra-Perez D, Valentini M, Benarroch G, Garcia-Valdecasas JC. Volvulus of the splenic flexure of colon: the coffee bean and whirl signs. Surgery. 2015;157:957–8.
Atamanalp SS. Sigmoid volvulus: diagnosis in 938 patients over 45.5 years. Tech Coloproctol. 2013;17:419–24.
Hayakawa K, Tanikake M, Yoshida S, et al. Radiological diagnosis of large-bowel obstruction: nonneoplastic etiology. Jpn J Radiol. 2012;30:541–52.
Finan PJ, Campbell S, Verma R, et al. The management of malignant large bowel obstruction: ACPGBI position statement. Color Dis. 2007;9(Suppl 4):1–17.
Megibow AJ. Bowel obstruction. Evaluation with CT. Radiol Clin N Am. 1994;32:861–70.
Macari M, Spieler B, Babb J, Pachter HL. Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus? Clin Radiol. 2011;66:112–7.
Poirier P, Alpert MA, Fleisher LA, et al. Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circulation. 2009;120:86–95.
Jiménez Fuertes M, Costa Navarro D. Resection and primary anastomosis without diverting ileostomy for left colon emergencies: is it a safe procedure? World J Surg. 2012;36:1148–53.
Kiran RP, Murray AC, Chiuzan C, et al. Combined preoperative mechanical bowel preparation with oral antibiotics significantly reduces surgical site infection, anastomotic leak, and ileus after colorectal surgery. Ann Surg. 2015;262:416–25.
Swenson BR, Kwaan MR, Burkart NE, et al. Colonic volvulus: presentation and management in metropolitan Minnesota, United States. Dis Colon Rectum. 2012;55:444–9.
Watt AM, Faragher IG, Griffin TT, et al. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007;246:24–30.
Jiménez-Pérez J, Casellas J, GarcÃa-Cano J, et al. Colonic stenting as a bridge to surgery in malignant large-bowel obstruction: a report from two large multinational registries. Am J Gastroenterol. 2011;106:2174–80.
Carne PW, Frye JN, Robertson GM, Frizelle FA. 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.
Abbott S, Eglinton TW, Ma Y, et al. Predictors of outcome in palliative colonic stent placement for malignant obstruction. Br J Surg. 2014;101:121–6.
Biondo S, Parés D, Kreisler E, et al. Anastomotic dehiscence after resection and primary anastomosis in left-sided colonic emergencies. Dis Colon Rectum. 2005;48:2272–80.
Deen KI, Madoff RD, Goldberg SM, Rothenberger DA. Surgical management of left colon obstruction: the University of Minnesota experience. J Am Coll Surg. 1998;187:573–6.
Breitenstein S, Rickenbacher A, Berdajs D, et al. Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction. Br J Surg. 2007;94:1451–60.
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Di Cataldo, A., Perrotti, S., Rivera, C., Lo Menzo, E. (2020). Large Bowel Obstruction in Obese Patients. In: Foschi, D., Navarra, G. (eds) Emergency Surgery in Obese Patients. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-17305-0_11
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DOI: https://doi.org/10.1007/978-3-030-17305-0_11
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