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One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer.
Am Surg. 2000 Jul; 66(7):619-22.AS

Abstract

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.

Authors+Show Affiliations

University of Milan-General Surgery, European Institute of Oncology, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10917469

Citation

Chiappa, A, et al. "One-stage Resection and Primary Anastomosis Following Acute Obstruction of the Left Colon for Cancer." The American Surgeon, vol. 66, no. 7, 2000, pp. 619-22.
Chiappa A, Zbar A, Biella F, et al. One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer. Am Surg. 2000;66(7):619-22.
Chiappa, A., Zbar, A., Biella, F., & Staudacher, C. (2000). One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer. The American Surgeon, 66(7), 619-22.
Chiappa A, et al. One-stage Resection and Primary Anastomosis Following Acute Obstruction of the Left Colon for Cancer. Am Surg. 2000;66(7):619-22. PubMed PMID: 10917469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer. AU - Chiappa,A, AU - Zbar,A, AU - Biella,F, AU - Staudacher,C, PY - 2000/8/5/pubmed PY - 2000/8/12/medline PY - 2000/8/5/entrez SP - 619 EP - 22 JF - The American surgeon JO - Am Surg VL - 66 IS - 7 N2 - 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. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/10917469/One_stage_resection_and_primary_anastomosis_following_acute_obstruction_of_the_left_colon_for_cancer_ L2 - https://medlineplus.gov/intestinalobstruction.html DB - PRIME DP - Unbound Medicine ER -