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Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding
R Farner1, W Lichliter, J Kuhn
1Department of Surgery, Baylor University Medical Center, Dallas, Texas 75246, USA.
Background:
Acute lower gastrointestinal bleeding (ALGB) of the colon can be problematic to diagnose. The purpose of this study was to review our experience with ALGBs and to determine any differences between limited colon resection (LCR) and total/subtotal colon resection (TCR).
Methods:
A retrospective study located 77 patients with ALGB, who required 2 or more units of packed red blood cells prior to surgery, and who were taken to the operating room from 1987 to 1997.
Results:
Fifty LCRs and 27 TCRs were performed during this 10-year period. Recurrent bleeding was significantly more common in the LCR group than in the TCR group (18% versus 4%). Morbidity and mortality were not significantly different.
Conclusions:
Owing to the misconception of a higher morbidity with TCR, it has been considered a "last resort" instead of a more expeditious therapy with similar morbidities and mortalities. TCR should be considered more often in the management of these patients.