Journal
COLORECTAL DISEASE
Volume 12, Issue 2, Pages 135-140Publisher
WILEY
DOI: 10.1111/j.1463-1318.2009.01771.x
Keywords
Multiple; synchronous; colonic; anastomoses; colon cancer; Crohn's disease
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Objective To evaluate short-term outcomes after construction of synchronous colonic anastomoses without fecal diversion. Method Using a prospective procedural database, all adult general surgery patients who underwent two synchronous segmental colon resections and anastomoses without ostomy at our institution from 1992-2007 were identified. Demographics, operative techniques, and 30-day outcomes are reported. Results are number (percent) of patients or median (interquartile range). Results Over 15 years, 69 patients underwent double colonic anastomoses [40 males, age 63 (45-76) years, BMI 25.3 (22.9-28.7) kg/m(2)]. Multiple colonic anastomoses were performed in one of every 201 colectomies during the study period (0.5%). The operation was an emergency in two (3%) cases; most cases were clean-contaminated 56 (81%). Ten (17%) cases were laparoscopic-assisted with a 44% conversion rate. Length of stay was seven (5-10) days. Overall 30-day morbidity was 36% including nine (13%) surgical site infections, two (2.9%) intra-abdominal abscesses requiring percutaneous drainage, and one (1.4%) wound dehiscence. There were no anastomotic leaks or fistulas, and two patients (2.9%) died within 30 days from pulmonary sepsis and complications from a distal anastomotic hemorrhage, respectively. Conclusions Synchronous colon anastomoses without fecal diversion do not appear to be associated with an increased risk of complications and can be safely constructed in selected patients.
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