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Intestinal obstruction after excision of the rectum
The British Journal of Surgery
|July 1, 1977
Summary
Leaving the pelvic peritoneum open after rectal excision can cause delayed intestinal transit, requiring reoperation in some cases. Mobilizing omentum to fill the pelvic cavity is recommended to mitigate these risks.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Pelvic Anatomy
Background:
- Rectal excision is a major surgical procedure.
- Pelvic peritoneum management is a critical surgical decision.
- Delayed intestinal transit is a significant post-operative complication.
Observation:
- Six of 33 patients undergoing rectal excision experienced delayed intestinal transit.
- This complication occurred when abdominal contents were allowed to fill the denuded pelvis.
- No similar pattern was observed in patients managed with other techniques.
Findings:
- Open pelvic peritoneum following rectal excision is associated with delayed intestinal transit.
- Delayed transit led to reoperation in two patients and mortality in one.
- The practice is considered unacceptable without omental mobilization.
Implications:
- Mobilizing omentum to occupy the pelvic cavity is crucial after rectal excision.
- This technique may prevent delayed intestinal transit and associated complications.
- Careful management of the pelvic space is essential for patient recovery.