A 70-year-old man presents with an acutely obstructing sigmoid colon cancer (T3N1M0). He is haemodynamically stable. The current preferred single-stage intervention is:

• A Hartmann's procedure followed by reversal in 3 months
• B Loop transverse colostomy as a bridge to elective resection
• C Self-expanding metallic stent (SEMS) as bridge to elective curative resection ✓
• D Emergency left hemicolectomy with on-table lavage and primary anastomosis

Explanation

For a stable patient with an obstructing left-sided colon cancer without perforation or ischaemia, endoscopic stenting with a self-expanding metallic stent (SEMS) as a bridge to elective surgery is the preferred approach. This converts an emergency procedure into an elective operation, allows bowel preparation, staging workup, and laparoscopic resection — reducing stoma formation rates and mortality. Hartmann's procedure has high morbidity and reversal rates are low in the elderly.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.