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[Emergency surgery of complicated diverticular disease of the colon]
J B d'Almeida1, J S Bessa, R Costa e Silva
1Hôpital S. José, Lisbonne, Portugal.
Insights
Emergency surgery for complications of colorectal cancer (CDDC) has limitations. Primary resection is possible with modern care, but immediate anastomosis should be avoided until local conditions improve, unlike in elective CDDC surgery.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Gastrointestinal emergencies
Abstract:
Emergency surgery is aimed at achieving the same results as elective surgery, but still has specific limitations in the case of CDDC, in spite of significant progress. We describe the physiopathological bases of the emergent treatment of the septic, occlusive and hemorrhagic complications of the CDDC, as well as the experience acquired in the Emergency Unit and Department 3 Hospital San José with 54 cases operated since 1981. The modern means of intensive care and preparation, including powerful antibiotics, make primary resection (1) as a principle possible, but do not allow yielding to the temptation of immediately creating an anastomosis as long as the local conditions have not improved. On the other hand, we emphasize the advantages of performing primary resection-anastomosis surgery in elective operations for non-emergent cases.