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Related Experiment Videos

Definitive one-stage emergency large bowel surgery.

K Mealy1, A Salman, G Arthur

  • 1Department of Surgery, Worthing District Hospital, West Sussex, UK.

The British Journal of Surgery
|December 1, 1988
PubMed
Summary

Emergency large bowel surgery, including resection and primary anastomosis, shows acceptable outcomes. This approach is effective for various conditions, even with peritonitis, demonstrating favorable morbidity and mortality rates.

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Area of Science:

  • Colorectal Surgery
  • Gastrointestinal Surgery
  • Emergency Medicine

Background:

  • Emergency large bowel conditions necessitate surgical intervention.
  • High morbidity and mortality are often associated with these emergencies.
  • The role of immediate resection and primary anastomosis is debated.

Purpose of the Study:

  • To evaluate the outcomes of emergency large bowel resections with primary anastomosis.
  • To assess the impact of underlying pathology and peritonitis on surgical results.
  • To determine the safety and efficacy of this surgical approach.

Main Methods:

  • Retrospective analysis of 126 emergency large bowel operations over 30 months.
  • Categorization of conditions including colonic carcinoma, diverticulitis, ischemia, and inflammatory bowel disease.

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  • Detailed recording of surgical procedures, including resection, anastomosis, and colostomy, and patient outcomes.

    • Main Results:

    • 110 patients (87.3%) underwent immediate resection, with 83 (65.9%) having primary anastomosis without colostomy.
    • Overall mortality was 14.3%, with lower rates in the primary anastomosis group (9.6%).
    • Complications included wound infection (10.3%) and anastomotic leak (7.2%) in the anastomosis without colostomy group.

    Conclusions:

    • Resection and primary anastomosis are feasible and safe for emergency large bowel conditions.
    • This approach offers acceptable morbidity and mortality across diverse pathologies and the presence of peritonitis.
    • Surgical strategy should prioritize resection and primary anastomosis when appropriate.