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Synchronous bowel anastomoses.

R L Whelan1, W D Wong, S M Goldberg

  • 1Department of Surgery, University of Minnesota, Minneapolis 55455.

Diseases of the Colon and Rectum
|May 1, 1989
PubMed
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Performing double bowel resections with synchronous anastomoses without diversion is safe. This study found complication rates comparable to single anastomoses, supporting the procedure under specific conditions.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Double bowel resections with synchronous anastomoses without diversion are complex procedures.
  • Assessing the safety and complication rates of these procedures is crucial for surgical decision-making.

Purpose of the Study:

  • To evaluate the incidence of complications in patients undergoing double bowel resections and synchronous anastomoses without ileostomy or colostomy.
  • To compare complication rates with those of single anastomoses.

Main Methods:

  • A retrospective review of 66 patients who underwent double bowel resections and synchronous anastomoses without diversion.
  • Patients were divided into two groups: Group A (two colonic resections/anastomoses) and Group B (colonic and small-bowel resections/anastomoses).

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  • Indications for surgery included adenocarcinoma, Crohn's disease, and diverticulitis.

    • Main Results:

    • Overall, four major (6%) and 11 minor (17%) complications occurred.
    • The single anastomotic leak (3%) was in a patient with double colonic resection.
    • Complication rates were comparable to those reported for single colonic anastomoses.

    Conclusions:

    • Synchronous anastomoses without diversion are safe when performed under optimal conditions.
    • Key conditions for safety include well-prepared bowel, adequate blood supply, technically sound anastomoses, and minimal tension.
    • This approach can be considered a viable option in selected patients.