Anterior resection without a defunctioning colostomy: questions of safety

✍ Scribed by K. Mealy; P. Burke; J. Hyland

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 330 KB
• Volume: 79
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800790406

✦ Synopsis

The need to defunction the anastomosis at anterior resection remains controversial. As the policy in this unit has been not to perform a defunctioning colostomy during anterior resection, the outcome of a consecutive series of 114 anterior resections, all carried out without a covering colostomy, was studied. During the period February 1985 to September 1991, 21 abdominoperineal resections, six Hartmann's procedures and two resections with coloanal anastomosis were also performed. Within the anterior resection group six clinical leaks (5.3 per cent) occurred, all in the low anastomosis group ( 8 per cent leak rate) and all of which required an end colostomy. The perioperative mortality rate within the anterior resection group was 3.5 per cent; of the four deaths one was attributable to anastornotic dehiscence and sepsis and the others were due to unassociated medical conditions.