Skip to main content

Advertisement

Log in

Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction

  • Published:
Diseases of the Colon & Rectum

Abstract

The management of acute distal colonic obstruction remains controversial. The advent of intraoperative colonic irrigation has allowed primary anastomosis to be performed in obstructed bowel. Fifteen patients, with acute distal obstruction due to carcinoma, diverticulitis or sigmoid volvulus were managed by primary resection and anastomosis. There were two leaks (14 percent) and the duration of operation was prolonged. In an experimental study of anastomotic healing after acute obstruction, intraoperative irrigation improved early anastomotic colonic collagen content (P<0.02) and perianastomotic proximal and distal collagen content (P<0.002,P<0.05). Intraoperative lavage is a useful technique to permit safer primary resection and anastomosis in obstructed colon.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Goligher JC. Diseases of the anus, colon and rectum. 5th ed. London: Bailliere Tindall, 1984.

    Google Scholar 

  2. Irvin TT, Greaney MG. The treatment of colonic cancer presenting with intestinal obstruction. Br J Surg 1977;64:741–4.

    PubMed  CAS  Google Scholar 

  3. Fielding LP, Wells BW. Survival after primary and after staged resection for large bowel obstruction caused by cancer. Br J Surg 1974;61:16–8.

    PubMed  CAS  Google Scholar 

  4. Clark J, Hall AW, Moossa AR. Treatment of obstructing cancer of the colon and rectum. Surg Gynecol Obstet 1975;141:541–4.

    PubMed  CAS  Google Scholar 

  5. White CM, Macfie J. Immediate colectomy and primary anastomosis for acute obstruction due to carcinoma of the left colon and rectum. Dis Colon Rectum 1985;28:155–7.

    PubMed  CAS  Google Scholar 

  6. Phillips RK, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction. Br J Surg 1985;72:296–302.

    PubMed  CAS  Google Scholar 

  7. Dudley HA, Radcliffe AG, McGeehan D. Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg 1980;67:80–1.

    PubMed  CAS  Google Scholar 

  8. Muir EG. Safety in colonic resection. Proc R Soc Med 1968;61:401–8.

    PubMed  CAS  Google Scholar 

  9. Koruth NM, Krukowski ZH, Youngson GG, et al. Intra-operative colonic irrigation in the management of left sided large bowel emergencies. Br J Surg 1985;72:708–11.

    PubMed  CAS  Google Scholar 

  10. Woessner JF Jr. The determination of hydroxyproline in tissue and protein samples containing small proportions of this imino acid. Arch Biochem Biophys 1961;93:440–7.

    Article  PubMed  CAS  Google Scholar 

  11. Fielding LP, Stewart-Brown S, Blesovsky L. Large-bowel obstruction caused by cancer: a prospective study. Br Med J 1979;2:515–7.

    Article  PubMed  CAS  Google Scholar 

  12. Boley SJ, Veith SJ. Effects of bowel distension on intestinal blood flow. In: Boley SJ, Schwartz SS, Williams LF, eds. Vascular disorders of the intestine. New York: Appleton Century Croft, 1971.

    Google Scholar 

  13. Sykes PA, Boulter KH, Schofield PF. The microflora of the obstructed bowel. Br J Surg 1976;63:721–5.

    PubMed  CAS  Google Scholar 

  14. Irvin TT. Collagen metabolism in infected colonic anastomoses. Surg Gynecol Obstet 1976;143:220–4.

    PubMed  CAS  Google Scholar 

  15. Yamakawa T, Patin CS, Sobel S, Morgenstern L. Healing of colonic anastomoses following resection for experimental “diverticulitis”. Arch Surg 1971;103:17–20.

    PubMed  CAS  Google Scholar 

  16. Smith SR, Connolly JC, Gilmore OJ. The effect of faecal loading on colonic anastomotic healing. Br J Surg 1983;70:49–50.

    PubMed  CAS  Google Scholar 

  17. Irvin TT, Goligher JC. Aetiology of disruption of intestinal anastomoses. Br J Surg 1973;60:461–4.

    PubMed  CAS  Google Scholar 

  18. Leaper DJ. Angiography as an index of healing in experimental laparotomy wounds and colonic anastomoses. Ann R Coll Surg Engl 1983;65:20–3.

    PubMed  CAS  Google Scholar 

  19. Jiborn H, Ahonen J, Zederfeldt B. Healing of experimental colonic anastomoses: the effect of suture technic on collagen concentration in the colonic wall. Am J Surg 1978;135:333–40.

    Article  PubMed  CAS  Google Scholar 

  20. Foster ME, Leaper DJ, Williamson RC. Changing patterns in colostomy closure: the Bristol experience 1975–1982. Br J Surg 1985;72:142–5.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Foster, M.E., Johnson, C.D., Billings, P.J. et al. Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction. Dis Colon Rectum 29, 255–259 (1986). https://doi.org/10.1007/BF02553031

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02553031

Key words

Navigation