An uncomplicated and safe way to perform on-table colonic lavage

Dafnis, George

doi:10.1007/s10151-004-0087-z

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…However, there is continuing debate on the practice of one‐stage surgery . For an obstructed left colon, various surgical approaches have been described as a total/subtotal or segmental colectomy and primary anastomosis accompanied by decompression of the distended colon manually, or by using a tube with or without irrigation . In selected patients, colonic stenting is another option as a bridge to elective surgery .…”

Section: Discussionmentioning

confidence: 99%

“…During the 1980s, segmental colectomy with ICI was suggested as an alternative approach . Since then, finding the most effective method for on‐table lavage has been of great clinical interest . It has been reported that the main concerns associated with ICI are prolonged operative time, risk of contamination, and lack of expertise .…”

Section: Discussionmentioning

confidence: 99%

“…Since then, different modifications using tubes have been described to remove the faecal load of the obstructed colon . However, these methods prolong the irrigation period and increase the risk of spillage and contamination, and afterwards, an additional intraoperative colonoscopy would be very cumbersome and time consuming . The availability of colonoscopy for theatres could also be problematic in emergency settings.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative underwater colonoscopy with a laparoscope following in‐sleeve on‐table colonic irrigation in obstructed left colon

Büyükgebiz

2013

Surgical Practice

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Aim:The aim of the present study was to describe intraoperative underwater colonoscopy (IUC) and recommend the use of this new technique in emergency settings for the management of acute left-sided colonic obstruction. Patients and Methods: IUC was performed with a laparoscope attached to a video-camera system after in-sleeve, on-table colonic irrigation. The colon was transected proximally to the tumour, and a nylon camera drape was sutured tightly to the proximal colonic end. Following colonic irrigation, the washout was stopped, and IUC was accomplished by introducing a laparoscope into the bowel. Finally, the laparoscope was withdrawn and formal surgery was performed. Results: IUC was successfully used in nine patients who underwent emergency colon surgery; eight patients had colonic obstructions due to adenocarcinomas, and one patient had colonic perforation. IUC revealed three synchronous lesions in the obstructed colonic segments which one of them was an adenocarcinoma in three patients. Another patient had a polyp located distally to the tumour, which was determined preoperatively. Primary resection and stapling anastomosis were performed in all cases. Postoperative complications were atelectasis and delay of intestinal motility in two patients; both recovered well. There was no complication due to IUC or primary operation; for example, anastomotic leakage or wound infection. During the follow up, one patient died 10 months after primary operation due to a cardiac event. Conclusion: IUC following in-sleeve, on-table irrigation is safe and quick to perform, and enables the assessment of colonic mucosa with good visibility. This method was found to be helpful to perform intraoperative colonoscopy when indicated in the emergency surgery of the obstructed left-sided colon when conventional endoscopy was not available at the theatre.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative underwater colonoscopy with a laparoscope following in‐sleeve on‐table colonic irrigation in obstructed left colon

Büyükgebiz

2013

Surgical Practice

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“…Today primary resection has become standard practice to treat patients with an obstructed left colon [2][3][4][5][6]. Initial insertion of an enteral stent to decompress the obstructed colon, allowing surgery to be performed electively, is gaining popularity [7], although mature data from large randomized trials are awaited.…”

Section: Introductionmentioning

confidence: 99%

Primary resection and side-to-end anastomosis next to an endcolostomy in the management of acute malignant obstruction of the left bowel: an alternative in selected patients

2009

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The concept of an end-colostomy next to the anastomosis is an alternative approach combining the safety of proximal decompression and the advantages of primary anastomosis. This technique may be considered in patients presenting with a massively distended and faeces-loaded colon caused by an obstructing tumour in the descending or sigmoid colon, when the surgeon would otherwise elect to defer anastomosis.

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An uncomplicated and safe way to perform on-table colonic lavage

Abstract: When surgery is performed in patients with acute or sub-acute left-colonic obstruction, the method of antegrade on-table colonic lavage is well established. In this short note, a modification of the original procedure is presented that makes it even more uncomplicated.

Cited by 2 publications

References 6 publications

Intraoperative underwater colonoscopy with a laparoscope following in‐sleeve on‐table colonic irrigation in obstructed left colon

Intraoperative underwater colonoscopy with a laparoscope following in‐sleeve on‐table colonic irrigation in obstructed left colon

Primary resection and side-to-end anastomosis next to an endcolostomy in the management of acute malignant obstruction of the left bowel: an alternative in selected patients

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