The Dudley colectomy in urgent and emergent situations: a 10 patient case series.

Left-sided colon pathology that needs to be treated in an emergency situation usually requires a partial colectomy and colostomy with a Hartmann's pouch. Primary anastomosis is avoided with an unprepped left colon due to the risk of post-operative anastomotic leakage. In this series, 10 patients were treated with on-table lavage to wash out the colon, and left colectomy with primary anastomosis in urgent and emergent situations without a protective ileostomy (the Dudley colectomy). All patients acutely recovered and none had an anastomotic leak. There was a single superficial wound infection, and a single late mortality due to heart failure. On-table colonic lavage and left colectomy with primary anastomosis without a protective ileostomy is a safe and effective way to treat left-sided colon emergencies without a protective ileostomy.