Tube decompression of the dilated colon

Khoo, Robert E.H.; Rothenberger, David A.; Wong, W. Douglas; Buls, John G.; Najarían, John S.

doi:10.1016/s0002-9610(88)80070-9

Cited by 9 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Colon perforation was found at laparotomy in only 2 patients (13%). Fourteen patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy as described by Khoo et al [10]. The 14 surgical procedures characterized by a subtotal colectomy differed exclusively for the treatment of the distal rectosigmoid stump: in 6 patients the distal rectosigmoid stump was implanted subcutaneously in the lower extremity of the wound and matured as a mucous fistula and since it was not technically feasible in the other 6 patients, the distal rectosigmoid stump was left at the pelvic brim (Hartman procedure).…”

Section: Resultsmentioning

confidence: 99%

Early Surgery for the Treatment of Toxic Megacolon

et al. 2005

View full text Add to dashboard Cite

Background: Toxic megacolon (TM) is a potentially lethal complication of idiopathic inflammatory bowel disease or infectious colitis, characterized by total or segmental non-obstructive colonic dilatation of at least 6 cm associated with systemic toxicity. Methods: Overall, 15 patients had surgery for TM at our institutions over a 10-year period (1993–2003). In contrast to other studies that used medical therapy as the first-line treatment for TM, in our experience all patients underwent surgery as soon as possible after diagnosis of TM (early surgery). Results: 14 patients underwent subtotal colectomy with terminal ileostomy, while for 1 patient the surgical procedure consisted only in a decompressive cecostomy. Two major complications occurred consisting of 2 cases of multiple organ failure leading to death. No other major complications or deaths were reported. The overall mortality rate was therefore 13% (0% in patients <65 years). Conclusion: This study shows that early surgery has the potential to represent a valid therapeutic strategy for patients with TM resulting in a small number of TM-related complications and deaths. Elderly patients seem to have a high risk of multiple organ dysfunction syndrome and post-surgical death.

show abstract

Section: Resultsmentioning

confidence: 99%

Early Surgery for the Treatment of Toxic Megacolon

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Although there is no firm evidence that decompression actually changes prognosis and outcome, it does have theoretical benefit and may facilitate the placement of a rectal catheter for permanent remnant drainage. 9 Surgical colonic decompression with ileostomy was performed in 3 patients with TM. In all patients, the postoperative period was severe, and the clinical condition deteriorated, which appeared in circulatory injury, septicemia, consumptive coagulopathy, and thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Treatment of Toxic Megacolon in Hirschsprung Disease

Khasanov

Schaible²,

Wessel³

et al. 2016

Pediatr Emer Care

View full text Add to dashboard Cite

show abstract

“…In fact, this particular type of technical approach merely represents an extension of the uncontroversial right hemicolectomy for right-sided lesions while taking advantage of better heal ing conditions of an anastomosis involving the ileum [19], where the apposition of collapsed, well-supplied with blood, supple and easily mobilizable intestinal segments, as it is definitely the case for the small bowel but also for the distal sigmoid colon, located beyond the obstructing tumor, adds to the anastomotic safety. The technical diffi culties that might, eventually, be offered by the manipula tion of a massively distended colon can be minimized by way of a simple deflating maneuver [25], A one-stage segmental colectomy would offer most of the aforementioned advantages without the inconve- nience of diarrhea, maintaining, as it does, the ileocecal valve with its corresponding function of promoting a suitable fluid and electrolytes resorption within the termi nal ileum. Nevertheless, such a technical modality on dis tended, fecal-loaded large bowel segments carries an un acceptable risk of poor anastomotic healing, leakage and sepsis.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Colectomy in the Management of Acutely Obstructed Left Colon Cancer

et al. 1992

View full text Add to dashboard Cite

One-stage subtotal colectomy of an acutely obstructed colon would improve quality of life while shortening the length of hospitalization. Prohibitive surgical risks, though, are commonly ascribed to such an approach. Analyzing the senior author’s experience we compared the one-stage approach versus multistaged resection concerning operative mortality and morbidity rates and the duration of hospital stay. Forty-nine out of 291 (17%) large bowel cancer patients presented with acute left-sided obstruction requiring emergency surgery. Colostomy alone was performed in 18 (37%), multistaged colectomy in 20 (41 %, group A) and one-stage subtotal colectomy in 11 (22%, group B), from January 1973 through September 1990. Both groups were comparable regarding age and sex distribution, TNM staging and ASA classification. Operative mortality and morbidity rates were 10 and 30% in group A and 9 and 18% in group B, respectively. The average length of hospital stay was more than twice the number of days in group A. Whenever an experienced surgical team is available and in the absence of contraindications (local factors precluding a swift dissection, hemodynamic instability, gangrenous bowel) a one-stage subtotal colectomy, taking advantage of a better healing ileo-low-sigmoid anastomosis, carries acceptable mortality and morbidity risks while enhancing the quality of life and shortening the length of hospitalization. It should be considered the procedure of choice, provided selection requirements and technical demands are met.

show abstract

Tube decompression of the dilated colon

Cited by 9 publications

References 0 publications

Early Surgery for the Treatment of Toxic Megacolon

Early Surgery for the Treatment of Toxic Megacolon

The Surgical Treatment of Toxic Megacolon in Hirschsprung Disease

One-Stage Colectomy in the Management of Acutely Obstructed Left Colon Cancer

Contact Info

Product

Resources

About