{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T18:45:31Z","timestamp":1767033931420},"reference-count":14,"publisher":"Royal College of Surgeons of England","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2008,5]]},"abstract":"INTRODUCTION<\/jats:title> Resection, on-table lavage (OTL) and primary anastomosis is the treatment of choice for the obstructed left colon. OTL is time-consuming, requires considerable mobilisation\/bowel handling, an enterotomy and potentially exposes the patient to mesenteric vascular injury, faecal contamination and a prolonged ileus. We have assessed outcome following primary resection and anastomosis without prior lavage. <\/jats:p><\/jats:sec>PATIENTS AND METHODS<\/jats:title> Twenty-four consecutive, obstructed patients underwent splenic flexure mobilisation and high anterior resection (concomitant small bowel resection in 2) with primary side-to-side colorectal anastomosis without either prior lavage or covering stoma. Outcome was audited. <\/jats:p><\/jats:sec>RESULTS<\/jats:title> Twenty-four patients, 17 female aged 48\u201392 years (median. 76 years) presented with left-sided obstruction due to carcinoma (Dukes' B [3], C [6], D [1]) or chronic diverticulitis (14). Median operative time was 85 min (range, 40\u2013105 min). Colonic ileus resolved on day 2 (29%) and day 3 (58%). Median hospital stay was 7 days (range, 6\u201372 days); 92% discharged by day 10. There were no deaths or re-admissions. A return to theatre followed a reactionary haemorrhage in one. This latter patient's anastomosis leaked on day 4 (no faecal contamination) and was converted to an end stoma. Urinary and wound infections were seen in two. Late complications comprised two anastomotic strictures; both responded to balloon dilatation at 5 months. <\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title> Resection and primary anastomosis without on-table lavage is an easy, practical, predictable and safe treatment option for left-sided colonic obstruction with minimal complications. <\/jats:p><\/jats:sec>","DOI":"10.1308\/003588408x285874","type":"journal-article","created":{"date-parts":[[2008,5,7]],"date-time":"2008-05-07T02:01:23Z","timestamp":1210125683000},"page":"302-304","source":"Crossref","is-referenced-by-count":18,"title":["Primary Anastomosis Without Colonic Lavage for the Obstructed Left Colon"],"prefix":"10.1308","volume":"90","author":[{"given":"KLR","family":"Cross","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, North Bristol NHS Trust, Frenchay Hospital Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JR","family":"Rees","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, North Bristol NHS Trust, Frenchay Hospital Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RHR","family":"Soulsby","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, North Bristol NHS Trust, Frenchay Hospital Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AR","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, North Bristol NHS Trust, Frenchay Hospital Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"b1","volume-title":"National audit of bowel obstruction due to colorectal cancer, April 1998 \u2013 March 1999","author":"Stamatakis J","year":"2000"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800780216"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1007\/BF02555634"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(82)90050-2"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196705000-00007"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4900"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.t01-2-02654.x"},{"key":"b8","first-page":"427","volume":"158","author":"Gandrup P","year":"1992","journal-title":"Eur J Surg"},{"key":"b9","first-page":"166","volume":"35","author":"Dixon AR","year":"1990","journal-title":"J R Coll Surg Edinb"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800790844"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049889"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1007\/BF01660714"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800821211"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1999.01230.x"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588408X285874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T09:57:29Z","timestamp":1684144649000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588408X285874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,5]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2008,5]]}},"alternative-id":["10.1308\/003588408X285874"],"URL":"https:\/\/doi.org\/10.1308\/003588408x285874","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,5]]}}}