PMID: 490687Oct 1, 1979Paper

Evaluation of management of the emergency right hemicolectomy

The Journal of Trauma
R N GarrisonH C Polk

Abstract

To evaluate the morbidity and mortality attending emergency resection of the right colon, we studied retrospectively 119 consecutive patients from two major centers, particularly examining the role of delayed anastomosis (initial ileostomy with subsequent ileocolic anastomosis). Emergency right colectomy was defined as an operative procedure in which partial resection of the terminal ileum and total or partial resection of the cecum and/or ascending colon were necessary before the colon could be evacuated and prepared as might be the case in elective resection. Ninety patients underwent primary anastomosis; hospital mortality and morbidity were 26 and 11%, respectively. Among 29 patients who underwent ileostomy, hospital mortality was 38%; hospital morbidity was 10%. In general, the patients selected for ileostomy were somewhat more ill or had more severe injury. only 17% of all deaths and 8% of all serious complications could be attributed to the anastomosis, leaving little statistical opportunity for improvement by deleting it. The data indicate that a very high mortality (29%) attends emergency right hemicolectomy. Our study indicates that ileostomy in lieu of anastomosis does not reduce this high mortality.

Citations

Oct 1, 1986·Diseases of the Colon and Rectum·R J NautaD B Walsh
Apr 1, 1981·Annals of Surgery·J S ThompsonJ B Moore
May 1, 1981·Annals of Surgery·L M FlintH C Polk
Jan 1, 1983·World Journal of Surgery·H C Polk, L M Flint
Oct 1, 1986·The Australian and New Zealand Journal of Surgery·B M SmithersN C Davis
Nov 11, 2016·Aging Clinical and Experimental Research·Renata TabolaJaroslaw Wierzbicki

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