Total colectomy of patients having synchronous lessons of five cases in Sylhet MAG Osmani Medical College, Bangladesh

Abstract

Background: Synchronous colorectal lesions present unique challenges in diagnosis and treatment, particularly in resource-limited settings. This study aims to evaluate the outcomes of total colectomy for synchronous colorectal lesions in a regional medical center in Bangladesh.

Methods: A retrospective case series of five patients who underwent total colectomy for synchronous colorectal lesions at Sylhet MAG Osmani Medical College Hospital between January 2019 and December 2023 was conducted. Patient demographics, clinical presentation, operative details, histopathological findings, and short-term outcomes were analyzed.

Results: The median age was 62 years (range: 48-75), with a male-to-female ratio of 3:2. The median number of synchronous lesions was 3 (range: 2-5). Three patients underwent open surgery, while two had laparoscopic-assisted procedures. The median operative time was 285 minutes (range: 240-360), with a median estimated blood loss of 350 mL (range: 200-600). Histopathology revealed adenocarcinoma in at least one lesion in three patients. The median length of hospital stay was 10 days (range: 8-15). Postoperative complications included ileus (n=2) and wound infection (n=1). No mortality or anastomotic leaks were observed within 30 days postoperatively. At 30-day follow-up, all patients reported satisfactory bowel function with a median stool frequency of 4 times per day.

Conclusion: Total colectomy for synchronous colorectal lesions can be safely performed with acceptable short-term outcomes in a regional medical center in Bangladesh. However, challenges remain in terms of resource availability and long-term follow-up. Further research is needed to optimize patient selection and perioperative management in resource-constrained settings.