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Title: | Surgical management of left colon obstruction: the University of Minnesota experience |
Authors: | Deen, K.I. Madoff, R.D. Goldberg, S.M. Rothenberger, D.A. |
Keywords: | Colonic Diseases Colonic Diseases-surgery Colorectal Neoplasms-surgery Intestinal Obstruction-surgery Postoperative Complications-surgery Proctocolectomy, Restorative Intestinal Perforation-surgery Retrospective Studies |
Issue Date: | 1998 |
Publisher: | Elsevier |
Citation: | Journal of American College of Surgeons. 1998; 187(6): pp.573-576 |
Abstract: | BACKGROUND: Management of left-sided colonic obstruction is a surgical challenge. This study was performed to review our management of patients with left colon obstruction presenting to the University of Minnesota Hospitals over a 10-year period, 1985 to 1994. STUDY DESIGN: We did a retrospective chart review of 143 patients (48 male and 95 female; mean age 70 years). RESULTS: Sites of obstruction were rectosigmoid, 40%; sigmoid colon, 47%; descending colon, 5%; and splenic flexure, 8%. Fifty-two percent of patients had obstructing colorectal cancer. Two patients presented with generalized peritonitis secondary to colonic perforation. The majority (n = 121, 85%) of patients underwent resection (subtotal in 39 [32%], and segmental in 82 [68%]) and anastomosis in a single stage after appropriate resuscitation. Intraoperative colonic cleansing was undertaken in 40 patients (28%). Morbidity within 30 days of operation was 11%, including 1 anastomotic leak, and mortality was 3%. The 4 deaths occurred in patients over 75 years of age and were not from anastomotic complications. CONCLUSIONS: A single stage resection and an anastomosis facilitated by intraoperative colonic cleansing in one-third of cases was performed in 85% of patients presenting with left colon obstruction. One anastomotic leak occurred. Our current policy of strongly favoring a single stage, definitive operation for patients presenting with left colon obstruction appears reasonable on the basis of this retrospective review of our experience. |
Description: | Indexed in MEDLINE |
URI: | http://repository.kln.ac.lk/handle/123456789/1354 |
ISSN: | 1072-7515 (Print) 1879-1190 (Electronic) |
Appears in Collections: | Journal/Magazine Articles |
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