Key result
Primary anastomosis fails to reduce 14-day mortality versus stoma formation in acute intestinal obstruction.
Why the study?
The study was conducted to evaluate and compare early postoperative outcomes between primary anastomosis and stoma formation alone following bowel resection in patients with GKN.
Does primary anastomosis compared to stoma formation improve early postoperative outcomes in patients with acute intestinal obstruction and peritonitis?
Cross-Sectional (n=63)
No
Does primary anastomosis compared to stoma formation improve early postoperative outcomes in patients with acute intestinal obstruction and peritonitis?
Answers are grounded in this paper and cite their sources.
In patients with acute intestinal obstruction and peritonitis, primary anastomosis is preferred for non-vascular etiologies, while stoma formation is preferred for vascular etiologies.
Summary. The aim of the study was to evaluate and compare the early postoperative outcomes of patients with GKN who received either primary anastomosis or only stoma formation after bowel resection with the identification of factors associated with postoperative complications and mortality in both groups of patients. Materials and methods. The study included 63 patients with acute intestinal obstruction and peritonitis who underwent resection of the small intestine followed by the formation of a jejunostomy. The factors affecting the choice of the option of completing the surgical intervention were studied. Research results. Under relatively equal conditions, after resection of the small intestine in patients with acute intestinal obstruction and peritonitis other than vascular etiology, preference should be given to interintestinal anastomoses with a Meidl jejunostomy for the purpose of «unloading», when obstruction caused by vascular pathology is detected — the preference is on the side temporary terminal uenostomy with staged interventions according to indications. Conclusions. After resection of the small intestine in case of non-vascular etiology, preference should be given to interintestinal anastomosis or Y-shaped anastomosis according to Meidl. The only risk factor for mortality is postoperative multiple organ failure.
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Olexander S. Olefir (2023) conducted a cross-sectional in Acute intestinal obstruction and diffused peritonitis (n=63). Primary anastomosis vs. Stoma formation (terminal jejunostomy or Meidl jejunostomy) was evaluated on 14-day postoperative mortality (p=0.469). Primary anastomosis did not significantly reduce 14-day postoperative mortality compared to stoma formation (41.2% vs 62.1%, p=0.469) in patients with acute intestinal obstruction and peritonitis.
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