Document Detail

One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer.
MedLine Citation:
PMID:  10917469     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to analyze the outcome in patients with acute obstruction of the left colon for cancer and treated by intraoperative decompression, on-table lavage, resection, and primary anastomosis. Between March 1992 and May 1998, 50 patients with acute obstruction of the left colon for cancer underwent surgery. Of these, 39 patients (25 men and 14 women; mean age, 65 years; range, 23-89) were treated with intraoperative decompression, on-table lavage, resection, and primary anastomosis. Six patients (15%) had fecal localized peritonitis. Left colectomies were performed in 16 patients (32%), partial colectomies in 19 patients (38%), and anterior resections in 4 patients (8%). The primary anastomosis was intraperitoneal in 29 patients (74%) and below the peritoneal reflection of the rectum in 10 (26%). The postoperative course was uneventful in 30 of the 39 cases. One patient (3%) died (within 30 days from surgery) from septic shock and multiple organ failure syndrome. Anastomotic leakage was observed in 2 patients (6%). An intra-abdominal abscess occurred in one case (3%). Other common complications included wound infections in 3 patients (8%). This experience suggests that intraoperative decompression, on-table lavage, resection, and primary anastomosis can be performed safely in selected patients with acute obstruction of the left colon for cancer than in those with an anastomosis in the nondiverted colon. Anastomosis below the peritoneal reflection is also not a contraindication.
A Chiappa; A Zbar; F Biella; C Staudacher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  66     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-08     Completed Date:  2000-08-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  619-22     Citation Subset:  IM    
University of Milan-General Surgery, European Institute of Oncology, Italy.
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MeSH Terms
Acute Disease
Anastomosis, Surgical
Colectomy / adverse effects,  methods*
Colonic Neoplasms / complications*,  surgery*
Decompression, Surgical
Emergency Treatment*
Intestinal Obstruction / etiology*,  surgery*
Treatment Outcome

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