Abstract
Although there may be no clinical signs of tumors in patients with cob-rectal cancer, intestinal contents are sometimes blocked on the oral side of the tumor. This could lead to the following consequences during prepreparation of patients with cob-rectal cancer : intestinal flora may be reduced to 0.1-0.001 that in appear patients without cancer, and cancer cells from the tumor may appear in the content. We have found class N positive in 40 % of cytology in irrigation water after washing out the colonal lumen. We have engaged ED or IVH, for one week with no chemical or mechanical preparation of patients with colon cancer, but intestinal contents remained in 20 % of the patients. These contents can sometimes cause postoperative complications. There are two methods of decompression before and during surgical operation for colon cancer, with and without stenosis. One method is rectal prothesis ; a prosthetic instrument placed at the stenosis of the rectum with irrigation through the lumen of the instrument. Irrigation is possible in the whole colon for 3 to 4 days, after which a barium enema is possible to get information from the oral side of stenosis. Another method is irrigation of the whole colon from the oral stump after removing the tumor. As a result of either method of irrigation, remarkably fine operative maneuvers are possible, and we have seen no post operative comoplications. By using either of the two methods, the incidence of anastomotic leakage has been diminished compared operations without irrigation or rectal prosthesis. Thus, for preoprative patients with stenotic rectal cancer, a rectal prosthesis developed us has greatly improved prognosis.
