OBJECTIVE: To evaluate short-term outcomes after construction of synchronous colonic anastomoses without fecal diversion. METHOD: Using a prospective procedural database, all adult general surgery patients who underwent two synchronous segmental colon resections and anastomoses without ostomy at our institution from 1992-2007 were identified. Demographics, operative techniques, and 30-day outcomes are reported. Results are number (percent) of patients or median (interquartile range). RESULTS: Over 15 years, 69 patients underwent double colonic anastomoses [40 males, age 63 (45-76) years, BMI 25.3 (22.9-28.7) kg/m(2)]. Multiple colonic anastomoses were performed in one of every 201 colectomies during the study period (0.5%). The operation was an emergency in two (3%) cases; most cases were clean-contaminated 56 (81%). Ten (17%) cases were laparoscopic-assisted with a 44% conversion rate. Length of stay was seven (5-10) days. Overall 30-day morbidity was 36% including nine (13%) surgical site infections, two (2.9%) intra-abdominal abscesses requiring percutaneous drainage, and one (1.4%) wound dehiscence. There were no anastomotic leaks or fistulas, and two patients (2.9%) died within 30 days from pulmonary sepsis and complications from a distal anastomotic hemorrhage, respectively. CONCLUSIONS: Synchronous colon anastomoses without fecal diversion do not appear to be associated with an increased risk of complications and can be safely constructed in selected patients.
OBJECTIVE: To evaluate short-term outcomes after construction of synchronous colonic anastomoses without fecal diversion. METHOD: Using a prospective procedural database, all adult general surgery patients who underwent two synchronous segmental colon resections and anastomoses without ostomy at our institution from 1992-2007 were identified. Demographics, operative techniques, and 30-day outcomes are reported. Results are number (percent) of patients or median (interquartile range). RESULTS: Over 15 years, 69 patients underwent double colonic anastomoses [40 males, age 63 (45-76) years, BMI 25.3 (22.9-28.7) kg/m(2)]. Multiple colonic anastomoses were performed in one of every 201 colectomies during the study period (0.5%). The operation was an emergency in two (3%) cases; most cases were clean-contaminated 56 (81%). Ten (17%) cases were laparoscopic-assisted with a 44% conversion rate. Length of stay was seven (5-10) days. Overall 30-day morbidity was 36% including nine (13%) surgical site infections, two (2.9%) intra-abdominal abscesses requiring percutaneous drainage, and one (1.4%) wound dehiscence. There were no anastomotic leaks or fistulas, and two patients (2.9%) died within 30 days from pulmonary sepsis and complications from a distal anastomotic hemorrhage, respectively. CONCLUSIONS: Synchronous colon anastomoses without fecal diversion do not appear to be associated with an increased risk of complications and can be safely constructed in selected patients.
Authors: Byoung Chul Lee; Chang Sik Yu; Jihun Kim; Jong Lyul Lee; Chan Wook Kim; Yong Sik Yoon; In Ja Park; Seok-Byung Lim; Jin Cheon Kim Journal: Medicine (Baltimore) Date: 2017-03 Impact factor: 1.889
Authors: Emilio De Raffele; Mariateresa Mirarchi; Dajana Cuicchi; Ferdinando Lecce; Claudio Ricci; Riccardo Casadei; Bruno Cola; Francesco Minni Journal: World J Gastrointest Oncol Date: 2018-10-15