MANAGEMENT OF OBSTRUCTING LESIONS OF THE LEFT COLON BY RESECTION, ON-TABLE LAVAGE, AND PRIMARY ANASTOMOSIS

Background. The purpose of this study was to assess the feasibility an d safety of single-stage resection, on-table lavage, and primary anast omosis in patients presenting with obstruction of the left colon. Meth ods. The outcome of surgery in 73 consecutive patients presenting with obstruction of the left colon during a 5-year period was assessed in terms of perioperative complications and long-term survival. Results. Sixty-three patients (86%) underwent single-stage restorative procedur es. In this group there were four clinical anastomotic leaks (6%). How ever, there were no deaths as a result of leakage. There were four dea ths (6%) but these were not due to anastomotic leakage. Long-term surv ival rates compared favorably, stage for stage, with large published s eries of elective experience. Conclusions. We believe that resection, on-table lavage, and primary anastomosis constitute the operation of c hoice for most patients with acute obstruction of the left colon.