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Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon.
Am J Surg. 2005 Apr; 189(4):384-7.AJ

Abstract

BACKGROUND

Although acute obstruction of the right colon is usually handled by primary anastomosis following resection, many surgeons are reluctant to offer one-stage resection and anastomosis to patients with obstructive lesions of the left colon. The aim of the study is to compare the immediate result of one-stage resection and anastomosis for patients with acute complete obstruction of the right colon versus left colon.

METHODS

From January 1986 to December 2003, 214 cases of acute colonic obstruction were managed with one-stage resection and anastomosis by a single surgeon. Eighty patients were operated on for obstructive lesions of the right colon, 71 of them for carcinoma of the colon. Operative mortality was 10% (8/80); all except 2 patients died of respiratory failure. There were 2 cases (2.5%) of anastomotic leakage. One hundred thirty-four patients were operated on for obstructive lesions of the left colon, 127 of them for carcinomas of the colon and rectum. Operative mortality was 1.5% (2/134); both patients died of metastasis from the colorectal cancer following surgery. There were 3 cases (2.3%) of anastomotic leakage.

CONCLUSION

This experience suggests that an anastomosis can be performed as safely in patients with acute obstruction of the left colon as in those with acute obstruction of the right colon. Mortality following resection and anastomosis is actually lower in left than right colonic obstruction. Neither intraoperative irrigation nor routine subtotal colectomy was found to be necessary in patients with acute colonic obstruction. Intraoperative decompression should be considered in left and also right colonic obstruction prior to the anastomosis following colonic resection.

Authors+Show Affiliations

Division of Colon and Rectal Surgery, Department of Surgery, Mackay Memorial Hospital, #92, Section 2, Chung-San North Road, Taipei, Taiwan. tzuchi@ms2.mmh.org.tw

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15820447

Citation

Hsu, Tzu-Chi. "Comparison of One-stage Resection and Anastomosis of Acute Complete Obstruction of Left and Right Colon." American Journal of Surgery, vol. 189, no. 4, 2005, pp. 384-7.
Hsu TC. Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg. 2005;189(4):384-7.
Hsu, T. C. (2005). Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. American Journal of Surgery, 189(4), 384-7.
Hsu TC. Comparison of One-stage Resection and Anastomosis of Acute Complete Obstruction of Left and Right Colon. Am J Surg. 2005;189(4):384-7. PubMed PMID: 15820447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. A1 - Hsu,Tzu-Chi, PY - 2004/02/06/received PY - 2004/06/23/revised PY - 2004/06/23/accepted PY - 2005/4/12/pubmed PY - 2005/5/11/medline PY - 2005/4/12/entrez SP - 384 EP - 7 JF - American journal of surgery JO - Am. J. Surg. VL - 189 IS - 4 N2 - BACKGROUND: Although acute obstruction of the right colon is usually handled by primary anastomosis following resection, many surgeons are reluctant to offer one-stage resection and anastomosis to patients with obstructive lesions of the left colon. The aim of the study is to compare the immediate result of one-stage resection and anastomosis for patients with acute complete obstruction of the right colon versus left colon. METHODS: From January 1986 to December 2003, 214 cases of acute colonic obstruction were managed with one-stage resection and anastomosis by a single surgeon. Eighty patients were operated on for obstructive lesions of the right colon, 71 of them for carcinoma of the colon. Operative mortality was 10% (8/80); all except 2 patients died of respiratory failure. There were 2 cases (2.5%) of anastomotic leakage. One hundred thirty-four patients were operated on for obstructive lesions of the left colon, 127 of them for carcinomas of the colon and rectum. Operative mortality was 1.5% (2/134); both patients died of metastasis from the colorectal cancer following surgery. There were 3 cases (2.3%) of anastomotic leakage. CONCLUSION: This experience suggests that an anastomosis can be performed as safely in patients with acute obstruction of the left colon as in those with acute obstruction of the right colon. Mortality following resection and anastomosis is actually lower in left than right colonic obstruction. Neither intraoperative irrigation nor routine subtotal colectomy was found to be necessary in patients with acute colonic obstruction. Intraoperative decompression should be considered in left and also right colonic obstruction prior to the anastomosis following colonic resection. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/15820447/Comparison_of_one_stage_resection_and_anastomosis_of_acute_complete_obstruction_of_left_and_right_colon_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(05)00119-4 DB - PRIME DP - Unbound Medicine ER -