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The management of left-sided large bowel obstruction: an audit
1Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
Background:
The outcomes of patients admitted acutely to hospital with left-sided large bowel obstruction (LBO) were examined.
Methods:
All patients admitted to the colorectal service (University Department of Surgery, Wellington School of Medicine) with LBO between 1975 and 1990 were reviewed. Sixty-four patients with left-sided LBO were identified.
Results:
The most commonly found obstructing lesion was cancer. Two patients were not managed surgically. In 17.7% of patients there was development of postoperative respiratory complications and 16% developed wound problems following primary surgery. Fifty-nine patients survived their primary surgery and 45 had stomas. The stoma closure rate was 71.1% (32 of 45). The overall mortality rate for patients managed surgically was 6.5% (four of 62). The mortality rate for stoma formation was 4.3% (two of 47). The mortality rate for resection and then stoma closure was 3.2% (one of 32).
Conclusions:
This study has shown that a staged approach to the management of unselected patients with left-sided LBO is safe. Restoration of bowel continuity was achieved in 70% of patients.