Results of Left Colon Primary Anastomosis in Emergency Colon Disease from 1998 to 2008 in Alzahra Hospital, Isfahan, Iran

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Traditionally, left colon obstruction is managed by a multistage defunctioning colostomy and resection. This paper presents the complications of single stage operation on a series of patients managed by primary anastomosis.Methods: In this retrospective study with the use of the patients file we gained the number of emergency patients, the number of patients under emergency sigmoid volvolus and left sided colon obstructive cancer, and left-sided colonic lacerations caused by the trauma. Complications of patients who had emergency resection and anastomosis surgery were studied.Findings: 109 patients were afflicted with left-sided colon obstruction, 25 patients (22.9%) had left sided colon obstructive cancer, 16 patients (14.7%) left sided colon lacerations caused by trauma, and 68 patients (62.4%) had emergency sigmoid volvolus. Of the 109 patients, 46 patients (42.2%) underwent resection and primary anastomosis, 25 patients (22.9%) reduction, and 38 patients (34.9%) underwent colostomy. The average age of sigmoid volvolus was 58 years, left sided colon obstructive cancer 62 years, and left-sided colon lacerations caused by trauma was 23 years. In sigmoid volvolus of the 30 patients who underwent resection and primary anastomosis 5 died (16.7%). According to the existing information, of the 25 living patients no one had wound infection, abscess, anastomotic leakage, and only 1 patient (4%) had a second surgery. In left-sided colon obstructive cancer, of the 12 patients who underwent resection and primary anastomosis 4 patients died (33.3%), and from the 8 living patients only 1 patient had (12.5%) infection wound and 1 patient (12.5%) had abscess, no patients had anastomotic leakage, and 5 patients (62.5%) need second surgery. In left-sided colon lacerations caused by trauma the 4 patients had no complications, and there were no deaths. Conclusion: Regarding the results of this study it can be concluded that left colon primary anastomosis can be performed safely in selected patients with acute obstruction of left colon. 

Keywords

References

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Journal of Isfahan Medical School
Volume 29, Issue 164 - Serial Number 164
September and October 2012
Pages 2127-2141

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History

  • Receive Date: 23 August 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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