[Status of resection-anastomosis in emergency left-sided colon surgery]

Resection and primary anastomosis (RPA) in emergency left-side colon surgery is not universally performed because of anastomotic healing difficulties of unprepared, dilated, or inflamed colons. Ninety-three patients underwent emergency surgery for left-side colon disease. Sixty-three primary anastomoses were performed with a 16% mortality rate and a 6% incidence of anastomotic leakage. These results are similar to those reported in the literature, depending upon the pathology involved, and appear to justify resection and primary anastomosis in case of hemorrhage, trauma, and left-colonic obstruction. As for diverticular perforation with localized peritonitis, RPA can be attempted in some instances, if a protective stoma is added. Finally, in case of diffuse peritonitis, the Hartmann procedure still remains the safest method.