TRANSCAECAL ILEAL DIVERSION IN THE MANAGEMENT OF THE AT RISK DISTAL COLONIC ANASTOMOSIS

Transcaecal ileal diversion has been used in association with primary resection and anastomosis to defunction an elective distal colonic ana stomosis in 10 patients and to allow on-table colonic lavage with subs equent colonic defunction in 11 patients presenting as an emergency wi th distal colonic obstruction. Post-operative wound sepsis occurred in four patients (19%) with a clinical anastomotic leak in one patient. The median hospital stay was 14 (10-19) days. Transcaecal ileal divers ion is simple to perform. It may facilitate primary resection and anas tomosis in both the elective and emergency situation without increasin g morbidity, mortality or the hospital stay.