الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Colorectal cancer is the 3rd most common malignancy world wide, tumor growth can often results in intestinal obstruction,necessitating an emergency operation. Patients with obstructed left colon have bad prognosis as a variety of factors can negatively influence morbidity and mortality in surgery; old age, delayed admission, pre-existing co morbidity especially cardiopulmonary disorders, generalized peritonitis, requirement of bowel resection,current nutritional status and preoperative laboratory values.The optimal treatment for left-sided obstructive CRC remains controversial; treatment options include proximal diversion with subsequent staged resection and anastomosis, immediate resection with later restoration of bowel continuity or a single-stage immediate resection with primary anastomosis.In left-sided colorectal obstruction, massive intestinal contents impair view of the operative field making complete tumor excision and lymph node dissection difficult, anastomotic dehiscence is likely to occur duo to bad physiologic status , thus staged resection and anastomosis have been favored whereby a colostomy is initially performed, followed by resection and the restoration of bowel continuity by a second operation.The presence of septic shock, immunocompromised status and fecal peritonitis, are usually contraindications to one stage resection and anastomosis for fear of complications.However, one-stage resection and anastomosis have several advantages, including saving of time and reduction in hospital costs,avoidance of the risk of a second operation, avoidance of the trouble and embarrassment resulting from a temporary colostomy.An alternative choice for management of malignant colonic obstruction is endoscopic self-expanding metallic stents as it offers the chance for relief of obstruction without the formation of a stoma with low morbidity and mortality rates, it can achieve rapid non operative decompression with technical and clinical success, proved to be both safe and effective, as a palliative or as a ‘‘bridge-to-surgery’’.