Primary repair of anastomosis in emergency colonic surgery - abstract

ABSTRACT

Standard surgical practice still dictates that in the unprepared column the staged procedures of colostomy, bowel preparation and elective surgery should be done in preference to primary repair or resection and anastomosis. Because this traditional practice involves multiple operations with increased hospitalization, operation time, drug requirements and morbidity, a practice of routine one-stage repair in emergency colonic surgery was prospectively adopted from 1984. Since then, 45 emergency colonic operations were performed. Primary repair or resection and anastomosis were done in 41 cases (30 traumatic injuries, 9 left-sided obstructions and 2 others). Colostomy was performed in 4 cases where it was not regarded as technically possible or safe to carry out primary repair or anastomosis. The only anastomotic leak in 41 cases of primary repair or anastomosis resulted in minimal morbidity. Because of tremendous savings through use of a one-stage procedure, and the low complication rate, primary repair of anastomosis should be considered the treatment of choice in most emergency colonic operations (AU)