Primary anastomosis and diverting colostomy in diffuse diverticular peritonitis

Acta chirurgica Belgica
S Landen, P Nafteux

Abstract

Despite the well documented morbidity associated with its reversal, Hartmann's procedure remains the favoured option in patients with complicated diverticular disease in the presence of diffuse peritonitis. A prospective study was conducted to determine whether primary anastomosis with diverting colostomy constitutes a valid alternative to the Hartmann procedure. Between 1994 and 1998, all patients with diffuse peritonitis due to perforated diverticulitis of sigmoid origin underwent resection and primary anastomosis with diverting colostomy. Restoration of colonic continuity was programmed six weeks later, after verification of the anastomose by gastrografin enema. The group included 5 men and 15 women with a mean age of 72 years (32-97 years). The ASA classification of the patients was as follows: ASA II (n = 2), ASA III (n = 12), ASA IV (n = 3), ASA V (n = 3). The mean delay between onset of symptoms and surgery was 74 hours (8-215 hours). Operative mortality and morbidity was 15% (n = 3) and 50% respectively. No patients showed signs of suture disruption and this was confirmed by routine radiological controls of the anastomoses. Mean length of hospitalization was 20 +/- 10 days (SD; median: 18 days). Closure of the colostomy...Continue Reading

Citations

Mar 24, 2005·Diseases of the Colon and Rectum·Leon SalemDavid R Flum
Feb 22, 2008·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Thomas CarusHeiko Lienhard
Jun 3, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·P FrileuxM-A Frileux
Dec 15, 2018·Asian Journal of Endoscopic Surgery·Resta GiuseppeAnania Gabriele
Dec 29, 2004·Diseases of the Colon and Rectum·Leon Salem, David R Flum

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.