{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:14:27Z","timestamp":1753892067288,"version":"3.41.2"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Disposable enema kits are commonly used for bowel preparation, with the anal tube typically positioned near the rectal ampulla. This study assesses the feasibility and safety of deeply inserting an enema tube in cases of acute malignant left-hemicolon obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 42 patients who underwent emergency endoscopic decompression via a deeply inserted enema tube for acute malignant left-hemicolon obstruction from January 2021 to September 2024 at a single center, the Endoscopy Centre of the Affiliated Hospital of Putian University. This analysis covered intubation duration, the success rate of intubation, the obstruction relief rate, as well as associated adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty-six patients achieved successful tube placement, attaining a one-time success rate of 85.7% (36\/42). Following successful intubation, the abdominal circumference decreased to a mean of (85.2 \u00b1 3.0)% of the original value on the subsequent day (<jats:italic>P<\/jats:italic> &amp;lt; 0.01). Abdominal plain films depicted a significant reduction in both the quantity of gas-fluid levels and the maximal transverse diameter of the proximally obstructed colon [(4.5 \u00b1 1.2) cm versus (7.4 \u00b1 0.8) cm, P &amp;lt; 0.01]. Within 48 hours, C-reactive protein (CRP) levels plummeted by over 50%, and bowel sounds normalized within 2 - 5 days. During surgery, the bowel exhibited only slight or negligible dilation and edema, with no conspicuous fecal residues detected in the colonic cavity. Furthermore, no severe tube-related adverse events occurred either during or after intubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The application of deeply inserted enema tubes proves to be both feasible and safe in treating acute malignant left-hemicolon obstruction, thus presenting itself as a viable alternative approach in developing countries.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1522138","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:10:48Z","timestamp":1744171848000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries"],"prefix":"10.3389","volume":"15","author":[{"given":"Xinxiang","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huifeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conghua","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00366-7","article-title":"Global, regional, and national lifetime risks of developing and dying from gastrointestinal cancers in 185 countries: a population-based systematic analysis of GLOBOCAN","volume":"9","author":"Wang","year":"2024","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004324","article-title":"Long-term oncologic results after stenting as a bridge to surgery versus emergency surgery for Malignant left-sided colonic obstruction: A multicenter randomized controlled trial (ESCO trial)","volume":"272","author":"Arezzo","year":"2020","journal-title":"Ann Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002164","article-title":"Survival, healthcare utilization, and end-of-life care among older adults with Malignancy-associated bowel obstruction: comparative study of surgery, venting gastrostomy, or medical management","volume":"267","author":"Lilley","year":"2018","journal-title":"Ann Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s13017-024-00543-w","article-title":"Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago","volume":"19","author":"Perrone","year":"2024","journal-title":"World J Emerg Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-10780-4","article-title":"Stenting as bridge to surgery versus upfront emergency resection for non-metastatic left sided obstructing colorectal cancer: risk of peritoneal recurrence and long-term outcomes","volume":"38","author":"Lin","year":"2024","journal-title":"Surg Endosc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s00384-023-04489-4","article-title":"Which treatment strategy is optimal for acute left-sided Malignant colonic obstruction? 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