Evaluating the outcomes of primary anastomosis with hand-sewn full-circular reinforcement in managing perforated left-sided colonic diverticulitis

It is a challenge to avoid stoma formation in emergency surgery of perforated left-sided diverticulum. The hand-sewn full-circular reinforcement of the colorectal anastomosis is used during complete pelvic peritonectomy to avoid a diverting ileostomy. This study examined the effect of applying the r...

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Bibliographic Details
Published in:Annals of medicine and surgery 2022-10, Vol.82, Article 104728
Main Authors: Aoki, Hikaru, Yamanaka, Kenya, Kurimoto, Makoto, Hanabata, Yusuke, Shinkura, Akina, Harada, Kaichiro, Kayano, Masashi, Tashima, Misaki, Tamura, Jun
Format: Article
Language:English
Subjects:
Colonic diverticulitis
Hand-sewn full-circle reinforcement
Perforation
Primary anastomosis
Technical Note
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Summary:It is a challenge to avoid stoma formation in emergency surgery of perforated left-sided diverticulum. The hand-sewn full-circular reinforcement of the colorectal anastomosis is used during complete pelvic peritonectomy to avoid a diverting ileostomy. This study examined the effect of applying the reinforcement method to perforated left-sided colonic diverticulitis with respect to the permanent stoma rate and cost-effectiveness. This historical cohort study examined all patients who underwent emergency surgery for perforation of a left-sided diverticulum at the Hyogo Prefectural Amagasaki General Medical Center between July 2015 and September 2019. The cohort was divided into two groups: those who underwent conventional method (Group F) and those for whom the hand-sewn full-circular reinforcement method was actively performed (Group L). The number of patients who underwent emergency surgery which did not lead to an ostomy increased significantly from 12% (3/25) in Group F to 42% (11/26) in Group L (P = 0.0015). The rate of permanent stoma decreased from 80% in Group F to 27% in Group L (P 
ISSN:2049-0801
2049-0801
DOI:10.1016/j.amsu.2022.104728