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[Left colectomy with immediate anastomosis in emergency surgery].
Ann Chir. 1999; 53(10):1023-8.AC

Abstract

PURPOSE OF THE STUDY

A retrospective study of our experience with one-stage left colectomy for acute diverticulitis and obstruction with a review of the literature to more clearly define the indications of this procedure.

PATIENTS AND METHODS

30 patients were operated for acute diverticulitis (group 1) and 47 for obstruction (group 2). Only 7 patients (23%) of group 1 had an intraoperative colonic lavage while this was performed for all the patients of group 2.

RESULTS

The postoperative morbidity and mortality for the patients of group 1 and 2 were 37 and 28%, and 7 and 11% respectively. None of the patients of group 1 had clinical anastomotic leak, while this occurred in 2 patients (4%) of group 2. The mean hospital stay was 26 days for patients of group 1 and 17 days for patients of group 2.

CONCLUSIONS

Bowel obstruction should be treated by one-stage left colectomy and intraoperative colonic lavage for patients with low anaesthetic risks (ASA 1 and 2). Immediate anastomosis protected by colostomy or ileostomy could be proposed for patients with an intermediate risk (ASA 3). Patients with acute diverticulitis and a localized abscess or peritonitis should be treated with one-stage colectomy; an immediate protected anastomosis could be performed in patients with generalized purulent peritonitis while a Hartmann's type colectomy should be the reasonable option for fecal generalized peritonitis. Intraoperative colonic lavage does not seem mandatory.

Authors+Show Affiliations

Clinique de Chirurgie Digestive, Hôpital Cantonal Universitaire, Genève, Suisse.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

fre

PubMed ID

10670152

Citation

Ambrosetti, P, et al. "[Left Colectomy With Immediate Anastomosis in Emergency Surgery]." Annales De Chirurgie, vol. 53, no. 10, 1999, pp. 1023-8.
Ambrosetti P, Michel JM, Megevand JM, et al. [Left colectomy with immediate anastomosis in emergency surgery]. Ann Chir. 1999;53(10):1023-8.
Ambrosetti, P., Michel, J. M., Megevand, J. M., & Morel, P. (1999). [Left colectomy with immediate anastomosis in emergency surgery]. Annales De Chirurgie, 53(10), 1023-8.
Ambrosetti P, et al. [Left Colectomy With Immediate Anastomosis in Emergency Surgery]. Ann Chir. 1999;53(10):1023-8. PubMed PMID: 10670152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Left colectomy with immediate anastomosis in emergency surgery]. AU - Ambrosetti,P, AU - Michel,J M, AU - Megevand,J M, AU - Morel,P, PY - 2000/2/12/pubmed PY - 2000/3/4/medline PY - 2000/2/12/entrez SP - 1023 EP - 8 JF - Annales de chirurgie JO - Ann Chir VL - 53 IS - 10 N2 - PURPOSE OF THE STUDY: A retrospective study of our experience with one-stage left colectomy for acute diverticulitis and obstruction with a review of the literature to more clearly define the indications of this procedure. PATIENTS AND METHODS: 30 patients were operated for acute diverticulitis (group 1) and 47 for obstruction (group 2). Only 7 patients (23%) of group 1 had an intraoperative colonic lavage while this was performed for all the patients of group 2. RESULTS: The postoperative morbidity and mortality for the patients of group 1 and 2 were 37 and 28%, and 7 and 11% respectively. None of the patients of group 1 had clinical anastomotic leak, while this occurred in 2 patients (4%) of group 2. The mean hospital stay was 26 days for patients of group 1 and 17 days for patients of group 2. CONCLUSIONS: Bowel obstruction should be treated by one-stage left colectomy and intraoperative colonic lavage for patients with low anaesthetic risks (ASA 1 and 2). Immediate anastomosis protected by colostomy or ileostomy could be proposed for patients with an intermediate risk (ASA 3). Patients with acute diverticulitis and a localized abscess or peritonitis should be treated with one-stage colectomy; an immediate protected anastomosis could be performed in patients with generalized purulent peritonitis while a Hartmann's type colectomy should be the reasonable option for fecal generalized peritonitis. Intraoperative colonic lavage does not seem mandatory. SN - 0003-3944 UR - https://www.unboundmedicine.com/medline/citation/10670152/[Left_colectomy_with_immediate_anastomosis_in_emergency_surgery]_ L2 - https://medlineplus.gov/intestinalobstruction.html DB - PRIME DP - Unbound Medicine ER -