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PRIMARY ANASTOMOSIS IN EMERGENCY DISTAL COLONIC SURGERY AFTER ON‐TABLE COLONIC LAVAGE
Author(s) -
Kourtesis George J.,
Motson Roger W.
Publication year - 1988
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1988.tb00101.x
Subject(s) - medicine , colostomy , therapeutic irrigation , surgery , foley catheter , anastomosis , diverticular disease , sigmoid colon , stoma (medicine) , general surgery , catheter , rectum
The traditional operative management of emergency distal colon pathology has involved staged procedures, but recently Hartmann's operation has gained popularity. The indications for primary anastomosis without covering colostomy have remained controversial, but the technique of on‐table lavage has extended the use of this approach in the acute setting. A series of seven patients having this procedure for diverticular abscess (three), obstructing colonic carcinoma (one), perforating colonic carcinoma (one) and sigmoid volvulus (two) is presented. The saline irrigation is introduced by a Foley catheter inserted via the appendix stump and the effluent is diverted from the proximal colon by anaesthetic scavenger tubing. The lavage is continued until the effluent is clear and anastomosis performed with one‐layer interrupted absorbable sutures. There were no deaths in the series; one patient developed a wound infection and average hospitalization was 16 days (range: 6–31 days). Immediate anastomosis in selected cases of emergency distal colonic pathology is thus feasible and safe following on‐table colonic lavage.