Abstract

Research Article

Emergency laparoscopic left sided colonic resection with primary anastomosis: Feasibility and Safety

Mohamed Abdelhamid*, AM Rashad, MA Negida, AZ Garib, SS Soliman and TM EL-Gaabary

Published: 20 November, 2018 | Volume 2 - Issue 2 | Pages: 031-038

Patients undergoing laparoscopic surgery had a lower incidence of major complications, such as anastomotic leak, intra-abdominal bleeding, abscess, and evisceration. Controversies about the operative management of left colonic emergencies are decreasing. Nowadays there is worldwide shifting towards primary resection, on table lavage and primary anastomosis. The aim of this study is to record the safety of laparoscopic primary anastomosis in left-sided colonic emergencies.

Patients: The study was carried out at Beni-Suef University Hospital, in the period between January 2016 and July 2017. Twenty-six patients were included in this study, twelve with left colon cancer, twelve with left colonic complicated diverticulitis and two cases with sigmoid volvulus. Patients presented clinically with either obstruction or perforation. All patients were subjected to laparoscopic resection, on table lavage and primary anastomosis.

Method: Decompression was done prior to starting the intervention, followed by resection and on table lavage then colorectal anastomosis using the circular stapler. The study was approved by the ethical committee in the faculty.

Results: Mean operative time: 185 min (160- 245).

LOS: 12 (10- 18).

Leak: one in obstruction group and two in perforation group.

Redo one in perforation group.

Conclusion: Emergency laparoscopic left-sided colonic resection and primary anastomosis can be performed with low morbidity, however with caution if there was free perforation with peritonitis

Read Full Article HTML DOI: 10.29328/journal.ascr.1001021 Cite this Article Read Full Article PDF

Keywords:

Left colonic emergencies; diverticulitis; Left colon cancer

References

  1. Lee SY, Kwon HJ, Cho JH, Oh JY, Nam KJ, et al. Emergency laparoscopic left sided colonic resection with primary anastomosis: Feasibility and Safety mimicking appendiceal tumor: a case report. World J Gastroenterol. 2010; 16: 395-397. Ref.: https://goo.gl/mdd1aw
  2. Lisa-Gracia M, Martin-Rivas B, Pajaron-Guerrero M, Arnaiz-Garcia A. Abdominal actinomycosis in the last 10 years and risk factors for appendiceal actinomycosis: review of the literature. Turk J Med Sci. 2017; 47: 98-102. Ref.: https://goo.gl/FLcTkt
  3. Liu K, Joseph D, Lai K, Kench J, Ngu MC, et al. Abdominal actinomycosis presenting as appendicitis: two case reports and review. Journal of surgical case reports. J Surg Case Rep. 2016; 2016. Ref.: https://goo.gl/mh65Nd

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