Key result
One-stage subtotal colectomy for left colorectal emergencies significantly reduced hospital stay (10.53 vs 19.93 days; P=0.001) and operating time compared to Hartmann's technique.
Why the study?
Primary colonic anastomosis is traditionally not performed in an emergency, but there is a tendency toward primary anastomosis to avoid a second hospitalization and operation.
Does one-stage primary anastomosis subtotal colectomy improve surgical outcomes compared to Hartmann's technique in patients with left colorectal crises?
Cohort (n=30)
Does one-stage primary anastomosis subtotal colectomy improve surgical outcomes compared to Hartmann's technique in patients with left colorectal crises?
Absolute Event Rate: 10.53% vs 19.93%
p-value: p=0.001
One-stage subtotal colectomy for left colonic emergencies reduces operative time and hospital stay compared to Hartmann's procedure without increasing mortality.
May shorten stays in left colorectal emergencies; hypothesis-generating and should not yet change practice.
Background: Traditionally, primary colonic anastomosis is not performed in an emergency, however, there is a current tendency toward primary anastomosis in order to avoid a second hospitalization and a second operation to reestablish intestinal continuityAim of the work: This study aimed to evaluate the surgical results of one-stage versus multiple-stage surgery in patients with left colorectal crises. Patients and methods: This prospective study was conducted on 30 patients. Fifteen patients agreed to have a one-stage primary anastomosis subtotal colectomy [group A]. Hartmann's technique was performed on the remaining 15 patients [group B]. Inoperable colorectal cancer and severe septic shock were exclusion criteria. Results: Males outnumbered females in both categories. Colorectal cancer was the most prevalent cause in both groups, accounting for 16 cases. Postoperative complications in group A were two [10%] cases of wound infection, three [20%] cases of prolonged ileus, two [13.3%] cases of chest infection, two [13.3%] cases of anastomotic leakage, which were managed conservatively, and closed without the need of intervention within 3 weeks, whereas in group B, there were 11 [73.4%] cases with no complication, two [13.3%] cases had wound infection, and two [13.3%] cases anastomotic leakage after Hartman’s reversal, which was also treated conservatively and closed without the need of intervention within 5 weeks. The operating time in group A was substantially less than in group B [161.87±28.015 vs. 252.53±28.648min; P 0.001]. Group A patients had a considerably shorter hospital stay than group B patients [10.53±1.959 vs. 19.93±4.114 days; P 0.001]. There is no mortality in group A, but there is one instance in group B.Conclusion: A one-step surgical technique Subtotal colectomy for left colonic crises eliminates the inconvenience of a phased operation Hartmann's technique while reducing morbidity and mortality and offering a shorter operational time and hospital stay overall.
No takes yet. Share an insight, caveat, or question.
Al-Ramah et al. (2022) conducted a cohort in Left colorectal crises (n=30). One-stage primary anastomosis subtotal colectomy vs. Hartmann's technique was evaluated on Hospital stay (days) (p=0.001). One-stage subtotal colectomy for left colorectal emergencies significantly reduced hospital stay (10.53 vs 19.93 days; P=0.001) and operating time compared to Hartmann's technique.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: