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

Mohamed I Kassem, Hany M Elhaddad.

Abstract
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.

Key words: Acutely obstructed left colon, cancer colon, on-table colonic lavage, manual decompression, immediate anastomosis


 
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How to Cite this Article
Pubmed Style

Kassem MI, Elhaddad HM. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Arch Clin Exp Surg. 2017; 6(3): 138-148. doi:10.5455/aces.20161017105054


Web Style

Kassem MI, Elhaddad HM. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. http://www.ejmaces.com/?mno=228014 [Access: August 21, 2018]. doi:10.5455/aces.20161017105054


AMA (American Medical Association) Style

Kassem MI, Elhaddad HM. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Arch Clin Exp Surg. 2017; 6(3): 138-148. doi:10.5455/aces.20161017105054



Vancouver/ICMJE Style

Kassem MI, Elhaddad HM. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Arch Clin Exp Surg. (2017), [cited August 21, 2018]; 6(3): 138-148. doi:10.5455/aces.20161017105054



Harvard Style

Kassem, M. I. & Elhaddad, H. M. (2017) Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Arch Clin Exp Surg, 6 (3), 138-148. doi:10.5455/aces.20161017105054



Turabian Style

Kassem, Mohamed I, and Hany M Elhaddad. 2017. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Archives of Clinical and Experimental Surgery (ACES), 6 (3), 138-148. doi:10.5455/aces.20161017105054



Chicago Style

Kassem, Mohamed I, and 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 (ACES) 6 (2017), 138-148. doi:10.5455/aces.20161017105054



MLA (The Modern Language Association) Style

Kassem, Mohamed I, and 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 (ACES) 6.3 (2017), 138-148. Print. doi:10.5455/aces.20161017105054



APA (American Psychological Association) Style

Kassem, M. I. & Elhaddad, H. M. (2017) Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon. Archives of Clinical and Experimental Surgery (ACES), 6 (3), 138-148. doi:10.5455/aces.20161017105054





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