Abstract
All patients with left colon obstruction or infection admitted under the care of one surgical firm over a 2.5-year period underwent on-table colonic lavage and primary anastomosis. Results were compared with all other similar patients treated during the same period in the same health district (involving a stoma in all cases). No significant difference in perioperative mortality or morbidity between primary anastomosis and Hartmann's groups was demonstrated. Hartmann's procedure necessitated a stoma for over 2 months with an 11% incidence of stoma-related complications. The stoma was not reversed in 25% of cases. Total inpatient stay was an average of 14 days shorter (95% CI 4.7-22.7 days) for primary anastomosis compared with Hartmann's patients. On-table lavage with primary anastomosis should be standard treatment for left colon emergencies.
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Selected References
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- Dudley H. A., Racliffe A. G., McGeehan D. Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg. 1980 Feb;67(2):80–81. doi: 10.1002/bjs.1800670203. [DOI] [PubMed] [Google Scholar]
- Fielding L. P., Stewart-Brown S., Blesovsky L., Kearney G. Anastomotic integrity after operations for large-bowel cancer: a multicentre study. Br Med J. 1980 Aug 9;281(6237):411–414. doi: 10.1136/bmj.281.6237.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hunt T. K., Hawley P. R. Surgical judgment and colonic anastomoses. Dis Colon Rectum. 1969 May-Jun;12(3):167–171. doi: 10.1007/BF02617804. [DOI] [PubMed] [Google Scholar]
- Irvin T. T., Goligher J. C. Aetiology of disruption of intestinal anastomoses. Br J Surg. 1973 Jun;60(6):461–464. doi: 10.1002/bjs.1800600612. [DOI] [PubMed] [Google Scholar]
- Killingback M. Management of perforative diverticulitis. Surg Clin North Am. 1983 Feb;63(1):97–115. doi: 10.1016/s0039-6109(16)42932-4. [DOI] [PubMed] [Google Scholar]
- Koruth N. M., Krukowski Z. H., Youngson G. G., Hendry W. S., Logie J. R., Jones P. F., Munro A. Intra-operative colonic irrigation in the management of left-sided large bowel emergencies. Br J Surg. 1985 Sep;72(9):708–711. doi: 10.1002/bjs.1800720911. [DOI] [PubMed] [Google Scholar]
- Pain J., Cahill J. Surgical options for left-sided large bowel emergencies. Ann R Coll Surg Engl. 1991 Nov;73(6):394–397. [PMC free article] [PubMed] [Google Scholar]
- Roe A. M., Prabhu S., Ali A., Brown C., Brodribb A. J. Reversal of Hartmann's procedure: timing and operative technique. Br J Surg. 1991 Oct;78(10):1167–1170. doi: 10.1002/bjs.1800781006. [DOI] [PubMed] [Google Scholar]