The controversy of management of left-sided colon obstructions: our experience

S. Saber, Tamer M. Elmahdy, S. Elgarf, A. Swelam, Gamal Mousa, Mahmoud A. Eissa
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Abstract

The controversy of treatment of acute colonic obstruction between the classical Hartmann’s procedure (HP) and the on-table lavage technique with primary colorectal anastomosis (PCA) for a safe, tolerable, and definitive operation with the least complications is still standing. So we conducted this prospective study to distinguish between both techniques as regards the efficacy and safety. In group A (n _ 30) the conventional Hartmann’s procedure was done by colonic resection and construction of left-sided stoma. In the B group (n _ 30), colonic resection was followed by colonic lavage, then a primary two-layered anastomosis with covering ileostomy was performed. The whole postoperative outcomes were comparable between both techniques. We believe that on table lavage technique with colorectal anastomosis is a notable choice during the treatment of acute obstruction of the left colon.
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左侧结肠梗阻治疗的争议:我们的经验
在治疗急性结肠梗阻时,传统的哈特曼手术(HP)与带原发性结肠直肠吻合术(PCA)的台上灌洗技术之间,如何选择一种安全、可耐受、彻底且并发症最少的手术方法仍存在争议。因此,我们进行了这项前瞻性研究,以区分这两种技术的有效性和安全性。 A 组(n _ 30)采用传统的哈特曼手术,切除结肠并造左侧造口。在 B 组(30 人)中,结肠切除后进行结肠灌洗,然后进行原发性两层吻合并覆盖回肠造口。 两种技术的术后效果相当。 我们认为,在治疗左侧结肠急性梗阻时,台上灌洗技术与结肠直肠吻合术是一个不错的选择。
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