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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objective The aim of this study was to compare between the surgical outcomes of one-stage and multiple-stage surgery in patients with left colorectal emergencies. Background Classically a primary colonic anastomosis is not performed in the emergency conditions, but recently there is a trend toward primary anastomosis aiming to avoid second hospital admission and second operation required to re-establish intestinal continuity. Patients and methods This is a prospective randomized study that included 40 patients. A total of 20 patients agreed to undergo one-stage primary anastomosis subtotal colectomy (group A). The other 20 patients underwent Hartmann's procedure (group B). Exclusion criteria were inoperable colorectal cancer and profound septic shock. Results Males predominated females in both groups. The most common causes in both groups were colorectal cancer, in 16 cases. There was one case of leak in group A, whereas two cases of leak after the Hartman's reversal in group B. Operative time was significantly lower in group A compared with group B (154.25 ± 13.28 vs. 246.50 ± 45.77 min; P < 0.001). Hospital stay was significantly lower in group A compared with group B patients (10.0 ± 1.69 vs. 18.85 ± 5.55 days; P < 0.001). There is no mortality in group A, whereas in group B, there was one case. Conclusion One-stage surgical procedure subtotal colectomy for left colonic emergencies avoids the inconvenience of a staged operation Hartmann's procedure, without increasing morbidity and mortality and providing overall shorter operative time and duration of hospital stay.

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