Surgical options for left-sided large bowel emergencies.
Current choices of operation for left-sided large bowel emergencies have been established by a questionnaire sent to 218 consultant surgeons asking which operation they would perform under varying circumstances for obstructing sigmoid carcinoma and diverticular disease. A 92% response rate was obtained. Hartmann's procedure (with or without a mucus fistula) is the most popular operation for all conditions. Sigmoid colectomy with primary anastomosis is performed by 40% of surgeons for obstructing carcinomas, but less commonly in other situations. On-table lavage is rarely used, and the majority of anastomoses are not protected by a proximal stoma. Subtotal colectomy is very seldom employed, except when caecal perforation results from an obstructing carcinoma. Some surgeons perform a defunctioning colostomy alone even in the presence of a perforation.
Pain
J
J
King's College Hospital, London.
Cahill
J
J
D001291:Attitude of Health Personnel; D003082:Colectomy; D003125:Colostomy; D004239:Diverticulitis, Colonic / Q000601:surgery*; D004630:Emergencies; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery; D008505:Medical Staff, Hospital; D010533:Peritoneal Lavage; D010538:Peritonitis / Q000601:surgery; D012810:Sigmoid Diseases / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000601:surgery*