What is the recommended procedure for managing large bowel obstruction caused by rectal cancer?

When dealing with a large bowel obstruction caused by rectal cancer, the recommended procedure often involves performing a defunctioning loop colostomy. This approach is particularly relevant in cases where the obstruction is acute and there is a need to relieve symptoms while addressing the underlying pathology.

Defunctioning loop colostomy serves multiple purposes in this clinical scenario. Firstly, it alleviates the obstruction, allowing for bowel decompression and symptom relief. This is critical in preventing complications associated with bowel obstruction, such as perforation and sepsis. Secondly, it allows for proper assessment and management of the rectal cancer, whether through subsequent surgery or other treatments. By diverting the stool, this procedure helps prepare the patient for any necessary definitive surgeries at a later stage, facilitating a more controlled environment for surgical intervention.

In contrast, while options like endoscopic stenting or tumor resection might seem plausible, they may not be suitable in every acute case of obstruction. Endoscopic stenting could be effective in cases of more chronic obstruction but may not provide immediate and reliable decompression needed in an acute scenario. Tumor resection may not be feasible or safe in the setting of an acute obstructive situation, particularly if the patient's condition does not allow for a major re