Intraoperative drainage of intestinal contents in emergency surgical treatment of left-sided colonic obstruction.
OBJECTIVE
This study was undertaken to verify an original procedure, drainage through anastomosis (DTA), for one-stage operation in emergency surgical treatment of left-sided colonic obstruction.


METHODS
Twenty-two patients underwent emergency surgical treatment for left-sided colonic malignant obstruction between 2001 and 2005 either by DTA or conventional method (CM). The parameters evaluated consisted of the incidence of surgical wound infection, residual abscess, anastomotic leakage, presence of ileostomy, and postoperative hospital stay.


RESULTS
Surgical wound infection occurred in 1 patient (10%) in DTA and 8 patients (67%) in CM (p=0.02). The incidence of residual abscess was none (0%) in DTA and 1 patient (8%) in CM. Anastomotic leakage was not observed in either group. The incidence of the patients having ileostomy was none (0%) in DTA and 2 patients (17%) in CM. The postoperative hospital stay in DTA was a mean of 22.2 (range 19-24) days as compared to 28.5 (range 20-52) days in CM (p=0.03).


CONCLUSIONS
One-staged surgery with DTA is a safe procedure that minimizes the risk of intraoperative spillage of intestinal contents, which may allow safe one-staged operation for colorectal cancer with left-sided colonic obstruction.
Kawahara
Hidejiro
H
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. kawahide@jikei.ac.jp
Yoshimoto
Kazuhisa
K
Watanabe
Kazuhiro
K
Kobayashi
Susumu
S
Kashiwagi
Hideyuki
H
Yanaga
Katsuhiko
K
D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D004630:Emergencies; D005260:Female; D006801:Humans; D007081:Ileostomy; D007414:Intestinal Neoplasms / Q000601:surgery*; D007415:Intestinal Obstruction / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012007:Rectum / Q000601:surgery; D012086:Reoperation; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery