Obstructing/perforated carcinoma of the left colon treated by resection and the formation of a double colostomy.

Forty patients presenting with obstructing left colon tumours between 1975 and 1980 were treated by a modified Paul-Mikulicz resection. The hospital mortality was 5 per cent. Subsequent mortality was largely related to the stage of the tumour at presentation and was not higher than that to be expected after an elective resection. In 21 patients the procedure was palliative and 16 of these patients later died. The quality of palliation was reasonable in 80 per cent and poor in 20 per cent. Despite the need for a second hospital stay to close the colostomy, time in hospital accounted, on average, for less than one-tenth of the remaining lifespan in those having a palliative resection.