MANAGEMENT OF LEFT-SIDED COLONIC OBSTRUCTION BY SUBTOTAL COLECTOMY AND ILEOCOLIC ANASTOMOSIS

Objective: To assess complications and functional results of emergency subtotal colectomy with ileocolic anastomosis for acute left-sided co lonic obstruction. Design: Retrospective study. Setting: University ho spital, Netherlands. Subjects: 37 patients with acute left-sided colon ic obstruction. Interventions: Emergency subtotal colectomy with immed iate anastomosis (n = 20), Hartmann's procedure (n = 13) or double loo p transverse colostomy (n = 4). Main outcome measures: Mortality, morb idity, duration of hospital stay, frequency of defecation, and contine nce. Results: Morbidity after subtotal colectomy was 10% (n = 2) and m ortality 0. There was one anastomotic dehiscence that required a tempo rary ileostomy. Mean hospital stay was 15 days (range 10-31). All had adequate continence. After 6 weeks mean frequency of defecation was 3/ 24 hrs (range 2-6). 9 patients died within 2 years of metastatic disea se. Conclusions: Subtotal colectomy with ileocolic anastomosis is a su itable procedure for treating left-sided colonic obstruction provided that pelvic floor function is adequate and a skilled surgeon is availa ble.