[Colectomy in emergency surgery]

Unlike the standardised surgery of the right sided colic emergencies there is still a matter of debate on the emergency approach of the left colon and rectum. Between 1998 - 2007 on 32 patients (15 males, 17 females) we performed the single stage radical procedure total or subtotal colectomy. In the same period we performed 372 emergency operations for low intestinal occlusion. The patients had ages between 24 - 86 years, the admittance diagnosis was intestinal occlusion. The postoperative diagnosis was left colic carcinoma (n=23), strangulated hernia (n=2) strangulated incisional hernia (n=2), sigmoid volvulus (n=3) and synchronous colic carcinoma (n=2). All cases were submitted to surgery in the first 24 h of admission. Despite the presence of liver metastasis at the time of surgery in 2 patients, this had not contraindicate the radical procedure. 21 patients (65.62%) had a good evolution. The others 11 (34.38%) had postoperative complications: 2 anastomotic leakage (6.25%), 7 parietal infections (21.87%) and 2 death (6.25%). The total colectomy offers oncological radicality and satisfactory functional results. The disadvantage consists in postoperative diarrhea, gradually decreased with time.