Single stage primary anastomosis without colonic lavage for left-sided colonic obstruction due to acute sigmoid volvulus: a prospective study of one hundred and ninety-seven cases.
BACKGROUND
The purpose of this study was to examine the feasibility of single-stage resection and anastomosis for acute left-sided colonic obstruction due to acute sigmoid volvulus without intraoperative lavage. Mechanical bowel preparation has been shown to be unnecessary for elective colorectal surgery. Colonic decompression without intraoperative lavage may simplify operations in acute left-sided colorectal obstruction.


METHODS
Emergency resection of acute sigmoid volvulus was performed. This was followed by primary anastomosis without on-table lavage after closed bowel decompression.


RESULTS
A total of 197 patients underwent bowel decompression, resection and primary colonic anastomosis. Two patients developed anastomosis leak, requiring re-laparotomy, Hartmann's procedure and delayed closure. Two deaths occurred postoperatively; these were unrelated to the nature of the surgery. The mean hospital stay was 9.8 days.


CONCLUSIONS
Primary colonic anastomosis can be safely done for obstructed left colon due to acute sigmoid volvulus without intraoperative colonic lavage.
De
Utpal
U
Department Of Surgery, Bankura Sammalani Medical College, Bankura, West Bengal, India. utpalde@vsnl.net
Ghosh
Shibajyoti
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*; D007507:Therapeutic Irrigation