Related Experiment Videos
Primary small bowel anastomosis in generalised peritonitis
J S de Graaf1, H van Goor, R P Bleichrodt
1Department of Surgery, University Hospital, Groningen, The Netherlands.
The European Journal of Surgery = Acta Chirurgica
|January 1, 1996
Summary
Primary small bowel anastomosis is safe for patients with generalized peritonitis. Planned relaparotomies ensure safety, showing no anastomotic leaks in end-to-end repairs, offering an alternative to enterostomy.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Clinical Outcomes
Background:
- Generalized peritonitis from bowel perforation presents significant surgical challenges.
- Traditional management often involves enterostomy, which can lead to complications.
- Assessing the safety of primary anastomosis in this high-risk group is crucial.
Purpose of the Study:
- To evaluate the safety and efficacy of primary small bowel anastomosis.
- To compare outcomes with planned relaparotomies versus standard enterostomy.
- To determine the incidence of anastomotic leaks in patients with generalized peritonitis.
Main Methods:
- Retrospective study conducted at a university hospital.
- Involved 10 patients with generalized purulent peritonitis due to bowel perforation.
- Patients underwent bowel resection/wedge resection with primary anastomosis, followed by planned relaparotomies every 24-48 hours.
Main Results:
- Two patient deaths occurred overall.
- All 19 primary end-to-end anastomoses healed without complications.
- Four of 20 wedge excisions resulted in leaks; two patients developed non-anastomotic small bowel fistulas.
Conclusions:
- Primary end-to-end small bowel anastomosis with planned relaparotomies is a safe alternative.
- This approach offers a viable option compared to creating an enterostomy.
- It demonstrates favorable outcomes in selected patients with generalized purulent peritonitis.