3-WAY LAVAGE AND ACTIVE ASPIRATION TUBES FOR THE PREVENTION AND TREATMENT OF COLORECTAL DISUNIONS AND FOR ACUTE NECROSIS OF THE PANCREAS

We conceived and used from 1985 to 1992 a three- way trans-anastomotic tube for 183 left colectomies in order to prevent the disunion of col orectal anastomoses, and also to actively contribute to their treatmen t. The three-way lavage and aspiration tube was positioned during the suture of the anastomosis. One hundred and nine pre-tube anastomoses s erved as controls. Major intra-sub or entirely sub-peritoneal resectio ns were performed in 94.61% of the cases. The number of disunions decr eased from 4.85% to 1.09% including two cases with very low anatomoses with defective sutures. From July 1988 to 31 December 1992 there were no disunions in the 137 last anastomoses. The number of abdomino-peri neal amputations was reduced from 81/109 resections in the pre-tube pe riod to 37/183 in the with-tube period, i.e. from 42.63% to 16.81%. Al l of the disunions healed within 12-18 days. The length of hospitaliza tion declined from 19-20 days to 11.6 days (11 days in the last 137 ca ses). We also used a three-way tube in 9 cases of acute necrosis of th e pancreas. These cases require surgery as soon as possible. With or w ithout sequestrectomy.All nine of our cases were discharged after succ essful treatment between day 14 and 39, and all returned to normal act ivities, with the exception of persistent diabetes in one. Secondary o perations were never required.