The role of one-stage surgery in acute left-sided colonic obstruction

One-stage surgery with primary anastomosis is not widely accepted for acute left-sided colonic obstruction.

Forty-four patients representing our total admission for acute left-sided colonic obstruction over a 3-year period were evaluated with regard to their suitability for one-stage surgery and primary anastomosis.

Thirty-five patients (80%) were found to be suitable for this approach and the failures were mainly due to either the advanced nature of the malignant lesions or to their distal location, which precluded an anastomosis. The overall in-hospital mortality was 11%, but only 2 patients (6%) died in the one-stage surgery group, and these deaths were unrelated to anastomotic leakage. This latter complication occurred in 1 patient representing a leak rate of 3%.

We recommend, based on our results, the one-stage approach as an alternative to the more conventional primary resection and staged anastomosis.