Skip to main content
PMC home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1990 Nov;72(6):393–395.

Primary restorative colectomy in malignant left-sided large bowel obstruction.

S Dorudi 1, N M Wilson 1, R M Heddle 1
PMCID: PMC2499285  PMID: 2241061

Abstract

A series of 18 consecutive patients who underwent primary resection and immediate anastomosis as the treatment for malignant left-sided large bowel obstruction are presented. Intraoperative mechanical preparation of the colon was omitted. There was no clinical evidence of anastomotic dehiscence or wound infection. The mean duration of hospital stay was 11 days. It is suggested that colonic continuity can be restored immediately and safely without mechanical bowel preparation, providing attention is directed to constructing an anastomosis that has a good blood supply and is free from tension.

Full text

PDF
393

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. 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]
  3. Fielding L. P., Wells B. W. Survival after primary and after staged resection for large bowel obstruction caused by cancer. Br J Surg. 1974 Jan;61(1):16–18. doi: 10.1002/bjs.1800610105. [DOI] [PubMed] [Google Scholar]
  4. GOLIGHER J. C., SMIDDY F. G. The treatment of acute obstruction or perforation with carcinoma of the colon and rectum. Br J Surg. 1957 Nov;45(191):270–274. doi: 10.1002/bjs.18004519109. [DOI] [PubMed] [Google Scholar]
  5. GREGG R. O. The place of emergency resection in the management of obstructing and perforating lesions of the colon. Surgery. 1955 May;37(5):754–761. [PubMed] [Google Scholar]
  6. Glass R. L., Smith L. E., Cochran R. C. Subtotal colectomy for obstructing carcinoma of the left colon. Am J Surg. 1983 Mar;145(3):335–336. doi: 10.1016/0002-9610(83)90194-0. [DOI] [PubMed] [Google Scholar]
  7. Hawley P. R. Causes and prevention of colonic anastomotic breakdown. Dis Colon Rectum. 1973 Jul-Aug;16(4):272–277. doi: 10.1007/BF02587700. [DOI] [PubMed] [Google Scholar]
  8. Huddy S. P., Shorthouse A. J., Marks C. G. The surgical treatment of intestinal obstruction due to left sided carcinoma of the colon. Ann R Coll Surg Engl. 1988 Jan;70(1):40–43. [PMC free article] [PubMed] [Google Scholar]
  9. Irvin T. T., Bostock T. The effects of mechanical preparation and acidification of the colon on the healing of colonic anastomoses. Surg Gynecol Obstet. 1976 Sep;143(3):443–447. [PubMed] [Google Scholar]
  10. 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]
  11. Irvin T. T., Greaney M. G. The treatment of colonic cancer presenting with intestinal obstruction. Br J Surg. 1977 Oct;64(10):741–744. doi: 10.1002/bjs.1800641015. [DOI] [PubMed] [Google Scholar]
  12. Irving A. D., Scrimgeour D. Mechanical bowel preparation for colonic resection and anastomosis. Br J Surg. 1987 Jul;74(7):580–581. doi: 10.1002/bjs.1800740711. [DOI] [PubMed] [Google Scholar]
  13. Klatt G. R., Martin W. H., Gillespie J. T. Subtotal colectomy with primary anastomosis without diversion in the treatment of obstructing carcinoma of the left colon. Am J Surg. 1981 May;141(5):577–578. doi: 10.1016/0002-9610(81)90053-2. [DOI] [PubMed] [Google Scholar]
  14. Koruth N. M., Hunter D. C., Krukowski Z. H., Matheson N. A. Immediate resection in emergency large bowel surgery: a 7 year audit. Br J Surg. 1985 Sep;72(9):703–707. doi: 10.1002/bjs.1800720910. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Markham N. I., Greatorex R. A., Everett W. G. The value and significance of the limited barium enema examination following restorative resection for carcinoma of the rectum. Ann R Coll Surg Engl. 1987 May;69(3):116–118. [PMC free article] [PubMed] [Google Scholar]
  17. Matheson N. A., Irving A. D. Single layer anastomosis in the gastrointestinal tract. Surg Gynecol Obstet. 1976 Oct;143(4):619–624. [PubMed] [Google Scholar]
  18. Morgan W. P., Jenkins N., Lewis P., Aubrey D. A. Management of obstructing carcinoma of the left colon by extended right hemicolectomy. Am J Surg. 1985 Mar;149(3):327–329. doi: 10.1016/s0002-9610(85)80100-8. [DOI] [PubMed] [Google Scholar]
  19. Phillips R. K., Hittinger R., Fry J. S., Fielding L. P. Malignant large bowel obstruction. Br J Surg. 1985 Apr;72(4):296–302. doi: 10.1002/bjs.1800720417. [DOI] [PubMed] [Google Scholar]
  20. Schrock T. R., Deveney C. W., Dunphy J. E. Factor contributing to leakage of colonic anastomoses. Ann Surg. 1973 May;177(5):513–518. doi: 10.1097/00000658-197305000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Shorthouse A. J., Bartram C. I., Eyers A. A., Thomson J. P. The water soluble contrast enema after rectal anastomosis. Br J Surg. 1982 Dec;69(12):714–717. doi: 10.1002/bjs.1800691210. [DOI] [PubMed] [Google Scholar]
  22. Smith S. R., Connolly J. C., Gilmore O. J. The effect of faecal loading on colonic anastomotic healing. Br J Surg. 1983 Jan;70(1):49–50. doi: 10.1002/bjs.1800700119. [DOI] [PubMed] [Google Scholar]
  23. Thow G. B. Emergency left colon resection with primary anastomosis. Dis Colon Rectum. 1980 Jan-Feb;23(1):17–24. doi: 10.1007/BF02587195. [DOI] [PubMed] [Google Scholar]
  24. Valerio D., Jones P. F. Immediate resection in the treatment of large bowel emergencies. Br J Surg. 1978 Oct;65(10):712–716. doi: 10.1002/bjs.1800651012. [DOI] [PubMed] [Google Scholar]
  25. Welch J. P., Donaldson G. A. Management of severe obstruction of the large bowel due to malignant disease. Am J Surg. 1974 Apr;127(4):492–499. doi: 10.1016/0002-9610(74)90302-x. [DOI] [PubMed] [Google Scholar]
  26. White C. M., Macfie J. Immediate colectomy and primary anastomosis for acute obstruction due to carcinoma of the left colon and rectum. Dis Colon Rectum. 1985 Mar;28(3):155–157. doi: 10.1007/BF02554230. [DOI] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES