Park UC et al. (2004) Single-stage procedure with intraoperative colonoscopy and colonic irrigation in patients with obstructing left-sided colonic cancer. Int J Colorectal Dis 19: 487–492

Obstructing left-sided colon cancer can be treated surgically using a one-stage procedure, involving resection of the tumor and primary anastomosis with on-table antegrade irrigation. Conventional irrigation is problematic, however, and does not allow on-table colonoscopy. Park et al. have recently reported on their multicenter, prospective study of a new device, which has been designed to overcome these problems.

The investigators studied 151 patients with obstructing left-sided colon cancer. All patients underwent resection, primary anastomosis and on-table irrigation using the new intraoperative colonic irrigator (NICI) from the Korean company MITech. Half of the patients also underwent on-table colonoscopy by way of the device.

The time taken for irrigation was relatively short compared with conventional means, and a larger volume of fluid was delivered. There was a relatively low rate (1.3%) of anastomotic leakages, suggesting that the procedure is safe. On-table colonoscopy allowed the detection of synchronous polyps in 35 (47%) patients and led to extended resection due to malignancy of necrosis in 13 (17%) cases.

The authors conclude that the NICI device enables quick and easy on-table irrigation and colonoscopy, which should facilitate the one-stage resection and primary anastomosis procedure.