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Surgery of the Large Bowel for Emergent Conditions: Staged vs Primary Resection

Surgery of the Large Bowel for Emergent Conditions: Staged vs Primary Resection Abstract "Even were it desirable, it certainly is not possible completely to standardize the treatment of any disease." Cheever For 75 years surgeons have engaged in an ongoing debate over the choice of operation in patients with disease of the large bowel. The focal point of dispute at the present time concerns the management of patients with emergent conditions of the colon and rectum. There is general agreement that primary resection and end-to-end anastomosis can and should be performed in most patients with perforative and obstructive disease in the ascending and proximal transverse colon. A similar concensus is lacking with respect to identical conditions present in that segment of the large bowel distal to the transverse colon. In 1931, Cheever1 reported the experience at the Peter Bent Brigham Hospital with carcinoma of the colon and stated, "a general principle so widely accepted that it needs no support is that of References 1. Cheever, D.: The Choice of Operation in Carcinoma of the Colon , Ann Surg 94:705-716 ( (Oct) ) 1931.Crossref 2. Woodhall, J.P., and Ochsner, A.: Management of Perforated Injuries to Colon and Rectum in Civilian Practice , Surgery 29:305-320 ( (Feb) ) 1951. 3. Gregg, R.O.: The Place of Emergency Resection in the Management of Obstructing and Perforating Lesions of the Colon , Surgery 37:754-761 ( (May) ) 1955. 4. Ryan, P.: Emergency Resection and Anastomosis for Perforated Sigmoid Diverticulitis , Brit J Surg 45:611-616 ( (May) ) 1957-58.Crossref 5. Madden, J.L.: Primary Resection and Anastomosis in the Treatment of Perforated Lesions of the Colon , Amer Surg 31:781-786 ( (Dec) ) 1965. 6. Baronofsky, I.D.: Primary Resection and Aseptic End-to-End Anastomosis for Acute or Subacute Large Bowel Obstructions , Surgery 27:664-672 ( (May) ) 1950. 7. Byrne, R.V.: Primary Resection of the Colon for Perforated Diverticulum , Amer J Surg 112:273-278 ( (Aug) ) 1966.Crossref 8. Gerber, A., et al: Experiences With Primary Resection for Acute Obstruction of the Large Intestine , Surg Gynec Obstet 115:593-598 ( (Nov) ) 1962. 9. Lewis, J.E., and Hurwitz, A.: Surgical Treatment of Sigmoid Diverticulitis , Surgery 33:481-494 ( (April) ) 1953. 10. Smiley, D.F.: Perforated Sigmoid Diverticulitis With Spreading Peritonitis , Amer J Surg 3:431-434 ( (March) ) 1966.Crossref 11. Person, E.C., and O'Neill, E.A.: Evaluation of Various Operations for Carcinoma of the Right Colon: Comparative Study of 140 Cases , Int Abst Surg 90:320-331 ( (April) ) 1950. 12. Diethelm, A.G.; Sleisenger, M.H.; and Nickel, W.F.: Primary Resection in Acute Fulminating Ulcerative Colitis , Arch Surg 88:389-396 ( (March) ) 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Surgery of the Large Bowel for Emergent Conditions: Staged vs Primary Resection

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1969.01340120097015
Publisher site
See Article on Publisher Site

Abstract

Abstract "Even were it desirable, it certainly is not possible completely to standardize the treatment of any disease." Cheever For 75 years surgeons have engaged in an ongoing debate over the choice of operation in patients with disease of the large bowel. The focal point of dispute at the present time concerns the management of patients with emergent conditions of the colon and rectum. There is general agreement that primary resection and end-to-end anastomosis can and should be performed in most patients with perforative and obstructive disease in the ascending and proximal transverse colon. A similar concensus is lacking with respect to identical conditions present in that segment of the large bowel distal to the transverse colon. In 1931, Cheever1 reported the experience at the Peter Bent Brigham Hospital with carcinoma of the colon and stated, "a general principle so widely accepted that it needs no support is that of References 1. Cheever, D.: The Choice of Operation in Carcinoma of the Colon , Ann Surg 94:705-716 ( (Oct) ) 1931.Crossref 2. Woodhall, J.P., and Ochsner, A.: Management of Perforated Injuries to Colon and Rectum in Civilian Practice , Surgery 29:305-320 ( (Feb) ) 1951. 3. Gregg, R.O.: The Place of Emergency Resection in the Management of Obstructing and Perforating Lesions of the Colon , Surgery 37:754-761 ( (May) ) 1955. 4. Ryan, P.: Emergency Resection and Anastomosis for Perforated Sigmoid Diverticulitis , Brit J Surg 45:611-616 ( (May) ) 1957-58.Crossref 5. Madden, J.L.: Primary Resection and Anastomosis in the Treatment of Perforated Lesions of the Colon , Amer Surg 31:781-786 ( (Dec) ) 1965. 6. Baronofsky, I.D.: Primary Resection and Aseptic End-to-End Anastomosis for Acute or Subacute Large Bowel Obstructions , Surgery 27:664-672 ( (May) ) 1950. 7. Byrne, R.V.: Primary Resection of the Colon for Perforated Diverticulum , Amer J Surg 112:273-278 ( (Aug) ) 1966.Crossref 8. Gerber, A., et al: Experiences With Primary Resection for Acute Obstruction of the Large Intestine , Surg Gynec Obstet 115:593-598 ( (Nov) ) 1962. 9. Lewis, J.E., and Hurwitz, A.: Surgical Treatment of Sigmoid Diverticulitis , Surgery 33:481-494 ( (April) ) 1953. 10. Smiley, D.F.: Perforated Sigmoid Diverticulitis With Spreading Peritonitis , Amer J Surg 3:431-434 ( (March) ) 1966.Crossref 11. Person, E.C., and O'Neill, E.A.: Evaluation of Various Operations for Carcinoma of the Right Colon: Comparative Study of 140 Cases , Int Abst Surg 90:320-331 ( (April) ) 1950. 12. Diethelm, A.G.; Sleisenger, M.H.; and Nickel, W.F.: Primary Resection in Acute Fulminating Ulcerative Colitis , Arch Surg 88:389-396 ( (March) ) 1964.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1969

References