Feasibility and Safety of Intraoperative Colonoscopy after Segmental Colectomy and Primary Anastomosis
| Autor: | Vendie H. Hooks, Erika Simmerman, Ray S. King, P. Benson Ham |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Colonoscopy Retrospective cohort study General Medicine 030230 surgery Anastomosis medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Intraoperative colonoscopy 030220 oncology & carcinogenesis medicine Diverticular disease Colitis Laparoscopy business Proctitis |
| Zdroj: | The American Surgeon. 84:1175-1179 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481808400733 |
| Popis: | Patients presenting with near-obstructing colon lesions requiring segmental colectomy may benefit from intraoperative colonoscopy (IOC) after primary anastomosis for a more timely and accurate diagnosis of synchronous lesions. The aim of this study is to demonstrate the feasibility and safety of this technique. A retrospective cohort study of patients undergoing single-stage segmental colectomy and anastomosis at a single tertiary care institution from 2011 to 2013 was performed. One Hundred and sixty-eight consecutive patients underwent segmental colectomy and primary anastomosis of which 78 (46%) were unable to receive preoperative colonoscopy (POC) because of near-obstructing lesions and received IOC after the anastomosis. IOC detected synchronous adenomatous polyps in 24.4 per cent, diverticular disease in 19 per cent, and colitis/proctitis in 2.5 per cent. The IOC group was not significantly different from the POC group with regard to overall morbidity (31% vs 39% P = 0.45), anastomotic leakage (1.3% vs 0%, P = 0.46), or wound infection (5.1% vs 1.1%, P = 0.18). Operation time was 19 minutes longer in the intra-operative group, but overall length of hospital stay was not significantly different (6.4 ± 2.9 days vs 7.3 ± 4.6 days). In patients unable to receive POC because of partial obstruction, IOC after primary anastomosis is both feasible and safe for detecting proximal synchronous lesions. |
| Databáze: | OpenAIRE |
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