Management of obstructing lesions of the left colon by resection, on-table lavage, and primary anastomosis.

BACKGROUND

The purpose of this study was to assess the feasibility and safety of single-stage resection, on-table lavage, and primary anastomosis in patients presenting with obstruction of the left colon.

METHODS

The outcome of surgery in 73 consecutive patients presenting with obstruction of the left colon during a 5-year period was assessed in terms of perioperative complications and long-term survival.

RESULTS

Sixty-three patients (86%) underwent single-stage restorative procedures. In this group there were four clinical anastomotic leaks (6%). However, there were no deaths as a result of leakage. There were four deaths (6%) but these were not due to anastomotic leakage. Long-term survival rates compared favorably, stage for stage, with large published series of elective experience.

CONCLUSIONS

We believe that resection, on-table lavage, and primary anastomosis constitute the operation of choice for most patients with acute obstruction of the left colon.