Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon

Objective: The purpose of this work was to compare primary resection and immediate reconstruction after either manual decompression only or on-table lavage in the management of acutely obstructed left colonic lesions. Methods: This prospective study was conducted on 281 adult patients presenting to...

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Main Authors: Mohamed I Kassem, Hany M Elhaddad
Format: Article
Language:English
Published: GESDAV 2017-09-01
Series:Archives of Clinical and Experimental Surgery
Subjects:
Online Access:http://www.ejmanager.com/fulltextpdf.php?mno=228014
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author Mohamed I Kassem
Hany M Elhaddad
author_facet Mohamed I Kassem
Hany M Elhaddad
author_sort Mohamed I Kassem
collection DOAJ
description Objective: The purpose of this work was to compare primary resection and immediate reconstruction after either manual decompression only or on-table lavage in the management of acutely obstructed left colonic lesions. Methods: This prospective study was conducted on 281 adult patients presenting to the Emergency Surgical Department of the Main Alexandria University Hospital, Faculty of Medicine, Alexandria University, Egypt, during the period from February 2011 to March 2016. Patients were randomly divided pre-operatively into two groups: group A, in which on-table colonic lavage was performed prior to anastomosis and group B, where immediate anastomosis was carried out after manual decompression. Results: Both groups were similar with regards to demographic data and etiology of obstruction. Group B had shorter operation times, less respiratory complications, reduced need for intensive care admission, decreased wound infection and shorter hospital stays. No statistically significant difference was found between benign and malignant causes. The rate of anastomotic leak did not vary between either group. Conclusions: In favorable situations, omission of on-table lavage may be preferred for immediate anastomosis in obstructed left colonic emergencies. The technique is reliable and well-tolerated with no additional morbidity or mortality. [Arch Clin Exp Surg 2017; 6(3.000): 138-148]
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spelling doaj.art-1b04634f72444da0addf5ea3d02e5ebc2023-02-15T16:08:26ZengGESDAVArchives of Clinical and Experimental Surgery2146-81332017-09-016313814810.5455/aces.20161017105054228014Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colonMohamed I Kassem0Hany M Elhaddad1Department of Surgery, Gastrointestinal surgery unit, Faculty of medicine, Alexandria university, Egypt Department of Surgery, Gastrointestinal surgery unit, Faculty of medicine, Alexandria university, EgyptObjective: The purpose of this work was to compare primary resection and immediate reconstruction after either manual decompression only or on-table lavage in the management of acutely obstructed left colonic lesions. Methods: This prospective study was conducted on 281 adult patients presenting to the Emergency Surgical Department of the Main Alexandria University Hospital, Faculty of Medicine, Alexandria University, Egypt, during the period from February 2011 to March 2016. Patients were randomly divided pre-operatively into two groups: group A, in which on-table colonic lavage was performed prior to anastomosis and group B, where immediate anastomosis was carried out after manual decompression. Results: Both groups were similar with regards to demographic data and etiology of obstruction. Group B had shorter operation times, less respiratory complications, reduced need for intensive care admission, decreased wound infection and shorter hospital stays. No statistically significant difference was found between benign and malignant causes. The rate of anastomotic leak did not vary between either group. Conclusions: In favorable situations, omission of on-table lavage may be preferred for immediate anastomosis in obstructed left colonic emergencies. The technique is reliable and well-tolerated with no additional morbidity or mortality. [Arch Clin Exp Surg 2017; 6(3.000): 138-148]http://www.ejmanager.com/fulltextpdf.php?mno=228014Acutely obstructed left coloncancer colonon-table colonic lavagemanual decompressionimmediate anastomosis
spellingShingle Mohamed I Kassem
Hany M Elhaddad
Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
Archives of Clinical and Experimental Surgery
Acutely obstructed left colon
cancer colon
on-table colonic lavage
manual decompression
immediate anastomosis
title Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
title_full Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
title_fullStr Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
title_full_unstemmed Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
title_short Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon
title_sort colectomy and immediate anastomosis versus on table colonic lavage for the management of acutely obstructed left colon
topic Acutely obstructed left colon
cancer colon
on-table colonic lavage
manual decompression
immediate anastomosis
url http://www.ejmanager.com/fulltextpdf.php?mno=228014
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AT hanymelhaddad colectomyandimmediateanastomosisversusontablecoloniclavageforthemanagementofacutelyobstructedleftcolon