A Fischer1, H J Schrag, M Goos, R Obermaier, U T Hopt, P K Baier. 1. Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetterstrasse 55, 79106, Freiburg, Germany. andreas.fischer@uniklinik-freiburg.de
Abstract
BACKGROUND: Acute colorectal obstruction is a potentially life-threatening emergency that requires immediate surgical treatment. To avoid major postoperative complications, most surgeons advocate two-step surgery despite the increase in patient discomfort and cost. Various methods for performing one-step surgery have been reported including intraoperative colonic lavage, decompression with self-expandable metal stents, and transanal tube decompression. METHODS: The authors present their experience performing transanal colonic decompression for 51 patients. RESULTS: Endoscopic tube placement was successful for 43 (84%) of the 51 patients. The emergency clinical situation could be converted to semielective treatment in 37 cases (73%) (30 operations and 6 nonoperative interventions), and to an elective operation in 1 case. After successful colonic decompression, the rate of one-stage operations was 93% (28/30), as compared with 40% (4/10) if the decompression failed. CONCLUSION: Endoscopic tube decompression of acute colonic obstruction is an easy and cost-effective possibility for avoiding emergency operations with all their sequelae. Emergency surgery can be converted to semielective or elective surgery, markedly reducing the rate of staged operations.
BACKGROUND: Acute colorectal obstruction is a potentially life-threatening emergency that requires immediate surgical treatment. To avoid major postoperative complications, most surgeons advocate two-step surgery despite the increase in patient discomfort and cost. Various methods for performing one-step surgery have been reported including intraoperative colonic lavage, decompression with self-expandable metal stents, and transanal tube decompression. METHODS: The authors present their experience performing transanal colonic decompression for 51 patients. RESULTS: Endoscopic tube placement was successful for 43 (84%) of the 51 patients. The emergency clinical situation could be converted to semielective treatment in 37 cases (73%) (30 operations and 6 nonoperative interventions), and to an elective operation in 1 case. After successful colonic decompression, the rate of one-stage operations was 93% (28/30), as compared with 40% (4/10) if the decompression failed. CONCLUSION: Endoscopic tube decompression of acute colonic obstruction is an easy and cost-effective possibility for avoiding emergency operations with all their sequelae. Emergency surgery can be converted to semielective or elective surgery, markedly reducing the rate of staged operations.
Authors: E Tobaruela; J Camuñas; J M Enríquez-Navascúes; M Díez; T Ratia; A Martín; P Hernández; I Lasa; A Martín; J A Cambronero; J Granell Journal: Rev Esp Enferm Dig Date: 1997-01 Impact factor: 2.086