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Tube decompression of the dilated colon
R E Khoo1, D A Rothenberger, W D Wong
1Department of Surgery, University of Minnesota, Minneapolis 55455.
American Journal of Surgery
|September 1, 1988
Summary
This study presents a novel decompression technique for toxic megacolon, enabling safe colonic resection. This method avoids blowhole colostomies, improving patient outcomes by removing the septic source.
Area of Science:
- Gastroenterology
- Surgical Techniques
- Colorectal Surgery
Background:
- Toxic megacolon presents a surgical challenge due to massive colonic dilation.
- Standard surgical approaches may leave the septic source in situ, increasing morbidity.
- Left-sided colonic obstructions also necessitate effective decompression strategies.
Purpose of the Study:
- To describe a novel technique for decompressing a massively dilated colon.
- To enable safe and effective colonic resection in patients with toxic megacolon.
- To present an alternative to blowhole colostomies for toxic megacolon management.
Main Methods:
- A technique for effective colonic decompression is described.
- This method facilitates safe colonic resection.
- The technique also allows for on-table bowel preparation with antiseptic irrigation.
Main Results:
- The described decompression technique allows for safe colonic resection in all patients with toxic megacolon.
- This approach has been successfully used to expedite subtotal colectomy and ileosigmoid anastomosis for left-sided obstructions.
- It avoids leaving the septic colon within the abdominal cavity, unlike blowhole colostomies.
Conclusions:
- The described decompression technique is effective for managing massively dilated colons.
- It enables safe colonic resection in toxic megacolon and facilitates expedited subtotal colectomy.
- This method offers a superior alternative to blowhole colostomies in managing toxic megacolon.