[Three-way tube for lavage and active aspiration for prevention and treatment of colorectal disunion and for surgery of acute necrosis of the pancreas].
We conceived and used from 1985 to 1992 a three-way trans-anastomotic tube for 183 left colectomies in order to prevent the disunion of colorectal anastomoses, and also to actively contribute to their treatment. The three-way lavage and aspiration tube was positioned during the suture of the anastomosis. One hundred and nine pre-tube anastomoses served as controls. Major intra-sub or entirely sub-peritoneal resections were performed in 94.61% of the cases. The number of disunions decreased from 4.85% to 1.09% including two cases with very low anastomosis with defective sutures. From July 1988 to 31 December 1992 there were no disunions in the 137 last anastomoses. The number of abdomino-perineal amputations was reduced from 81/109 resections in the pre-tube period to 37/183 in the with-tube period, i.e. from 42.63% to 16.81%. All of the disunions healed within 12-18 days. The length of hospitalization declined from 19-20 days to 11.6 days (11 days in the last 137 cases). We also used a three-way tube in 9 cases of acute necrosis of the pancreas. These cases require surgery as soon as possible. With or without sequestrectomy. All nine of our cases were discharged after successful treatment between day 14 and 39, and all returned to normal activities, with the exception of persistent diabetes in one. Secondary operations were never required.
Gullino
D
D
Service de Chirurgie Générale et d'Urgence, Hôpital Départemental S.S. Annunziata, Savigliano, Italie.
Giordano
O
O
Cesari
M
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003082:Colectomy; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery; D003110:Colonic Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013396:Suction / Q000295:instrumentation* / Q000379:methods
Tube à trois voies, de lavage et aspiration active, dans la prévention et le traitement des désunions colo-rectales et dans la chirurgie de la nécrose aiguë du pancréas.