Separation Surgery for Unresectable Right-sided Colon Cancer as Palliation

Patients with acute colorectal obstruction due to malignancy in the right-sided colon are treated with primary resection and anastomosis. However, considering the generally poor status and prognosis, less-invasive, palliative treatment is desirable, particularly for unresectable malignancies. An ileostomy is useful, but the patient must manage the stoma, which worsens the quality of life. We developed a palliative surgical procedure, termed the “Separation surgery of the right-sided colon,” for treating an obstruction due to unresectable right-sided colon cancer. We identified and divided the ileum and the transverse colon and anastomosed the upper ileum to the lower transverse colon. Then, we created a mucous fistula with the loose ends of the lower ileum and the upper transverse colon. We performed this procedure in five patients. Stoma pouches were unnecessary. No comorbidities were observed, including anastomotic leakage. The “Separation surgery of the right-sided colon” was useful as palliative surgery.