The role of one-stage surgery in acute left-sided colonic obstruction.
BACKGROUND
One-stage surgery with primary anastomosis is not widely accepted for acute left-sided colonic obstruction.


METHODS
Forty-four patients representing our total admission for acute left-sided colonic obstruction over a 3-year period were evaluated with regard to their suitability for one-stage surgery and primary anastomosis.


RESULTS
Thirty-five patients (80%) were found to be suitable for this approach and the failures were mainly due to either the advanced nature of the malignant lesions or to their distal location, which precluded an anastomosis. The overall in-hospital mortality was 11%, but only 2 patients (6%) died in the one-stage surgery group, and these deaths were unrelated to anastomotic leakage. This latter complication occurred in 1 patient representing a leak rate of 3%.


CONCLUSIONS
We recommend, based on our results, the one-stage approach as an alternative to the more conventional primary resection and staged anastomosis.
Lau
P W
PW
Department of Surgery, Queen Mary Hospital, University of Hong Kong.
Lo
C Y
CY
Law
W L
WL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D007507:Therapeutic Irrigation; D017211:Treatment Failure