Left Colonic Anastomosis without Protective Stoma

Abstract

Background: Protective stoma formation following resection and anastomosis of the colon is a common practice despite evidence of increased mortality and poor patient satisfaction. However, evidence regarding primary resection and anastomosis of lest colon without protective stoma formation is relative scarce. Methods: This cross-sectional study was conducted at the department of Surgery in Bangladesh Medical College & Hospital, Dhaka for six months of period. Patients requiring colonic resection specially in the left colon with colo-colic and colo-rectal anastomosis without any covering ileostomy or colostomy were included in this study. Before final selection, all participants were screened in according to the inclusion & exclusion criteria. Before interviewing and hospital record analysis, written informed consent was taken from each subject and ethical issues was ensured properly. Data was collected from a total 30 patients and recorded into a structured questionnaire. Collected data was analyzed by the SPSS 23. Results: total 30 patients were included and mean age of them were 52.83(±10.53) years. About 67% (n=20) were male and 33% (n=10) were female. Of all, 63.30% patients were finally diagnosed as a case of Neoplasm followed by Sigmoid Volvulus (26.7%), Diverticulitis (6.70%), and others 3.30%. most frequent post-operative events were infection which occurred in 16.7% (n=5) cases. Paralytic ileus had developed in 4(13.3%) patients and Anastomic leakage had occurred in 1(3.3%) patient. Mean duration of hospital stay was 08(±1.61) days. Conclusion: The common indication for left colonic resection and anastomosis was neoplasm and infection were the most common post-operative complication.