Abstract
The treatment of choice for left sided colonic obstruction is still controversial. We tried primary resection and anastomosis with the aid of intraoperative irrigation of the dilated proximal colon. Twenty-one cases of obstructive carcinoma of the left colon and four cases of sigmoid colon volvulus were managed using this approach. After the antegrade or retrograde intraoperative irrigation, primary resection and anastomosis without colostomy was performed in all 25 cases. There was only one case with anastomotic leakage. The satisfactory results of our present study and of the previous reports of intraoperative irrigation lead us to recommend intraoperative irrigation and primary anastomosis for left sided colonic obstruction except when the general condition of a patient is very poor or when the prognosis is expected to be poor due to the advanced spread of carcinoma.
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References
Irvin TT, Goligher JC (1973) Aetiology of disruption of intestinal anastomoses. Br J Surg 60:461–464
Irvin TT, Greaney MG (1977) The treatment of colonic cancer presenting with intestinal obstruction. Br J Surg 64:741–744
Smith SRG, Connolly JC, Gilmore OJA (1983) The effect of faecal loading on colonic anastomotic healing. Br J Surg 70:49–50
Atik M, Castleberry JW, Werner JC, Cohn I (1960) An experimental study of primary anastomosis of the obstructed colon. Surg Gynecol Obstet 109:697–701
White CM, Macfie J (1985) Immediate colectomy and primary anastomosis for acute obstruction due to carcinoma of the left colon and rectum. Dis Colon Rectum 28:155–157
Welch JP, Donaldson GA (1974) Management of severe obstruction of the large bowel due to malignant disease. Am J Surg 127:492–499
Clark J, Hall AW, Moossa AR (1975) Treatment of obstructing cancer of the colon and rectum. Surg Gynecol Obstet 141:541–544
Carson SN, Poticha SM, Shields TW (1977) Carcinoma obstructing the left side of the colon. Arch Surg 112:523–526
Phillips RKS, Hittinger R, Fry JS, Fielding LP (1985) Malignant large bowel obstruction. Br J Surg 72:296–302
Muir EG (1968) Safety in colonic resection. Proc R Soc Med 61:401–408
Dudley HAF, Radcliffe AG, McGeehan D (1980) Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg 67:80–81
Radcliffe AG, Dudley HAF (1983) Intraoperative antegrade irrigation on the large intestine. Surg Gynecol Obstet 156:721–723
Koruth NM, Krukowski ZH, Youngson GG, Hendry WS, Logie JRC, Jones RF, Munro A (1985) Intra-operative colonic irrigation in the management of left-sided large bowel emergencies. Br J Surg 72:708–711
Pollock AV, Playforth MJ, Evans M (1987) Peroperative lavage of the obstructed left colon to allow safe primary anastomosis. Dis Colon Rectum 30:171–173
Thomson WHF, Carter SStC (1986) On-table lavage to achieve safe restorative rectal and emergency left colonic resection without covering colostomy. Br J Surg 73:61–63
Foster ME, Johnson CD, Billings PJ, Davies PW, Leaper DJ (1986) Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction. Dis Colon Rectum 29:255–259
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Konishi, F., Muto, T., Kanazawa, K. et al. Intraoperative irrigation and primary resection for obstructing lesions of the left colon. Int J Colorect Dis 3, 204–206 (1988). https://doi.org/10.1007/BF01660714
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DOI: https://doi.org/10.1007/BF01660714