[Secure anastomoses of the large intestine (especially with transanal drainage].
The results of colonic resections were investigated in 356 patients in a retrospective analysis. Special attention was directed to the effectiveness of a transrectal tube, leading to decompression of the anastomosis for the first five days. Under elective conditions, the overall complication-rate was 12.7%. In emergency cases, these complications were 51.5% (one third of these cases had a decompression-tube). The clinical relevant leakage-rate under elective conditions ranged to 1.7%. Postoperative mortality related to surgical complications turned out to be 1.5% under elective conditions. The emergency operations had a high mortality which ranged to approximately 15.2%. No patient with leakage of a colorectal anastomosis died when the transrectal decompression-tube was applied. Such a safety in anastomotic healing of colon and rectum anastomoses can otherwise only be achieved by using the protection of a diverting colostomy or ileostomy. The use of the transrectal decompression-tube also avoids stomal complications and the second operation. There is no indication for the decompression-tube in emergency operations with purulent or faecal peritonitis. In these cases a fundamentally different treatment is mandatory.
Klein
P
P
Klinik für Allgemein- und Visceralchirurgie, St. Elisabethen-Krankenhaus, Ravensburg.
Immler
F
F
Sterk
P
P
Schubert
F
F
D011125:Adenomatous Polyposis Coli / Q000401:mortality / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D002423:Cause of Death; D003082:Colectomy / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation*; D017558:Elective Surgical Procedures; D004630:Emergencies; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D015996:Survival Rate; D013536:Suture Techniques / Q000295:instrumentation