Evaluation of management of the emergency right hemicolectomy

R. Neal Garrison, Eugene H. Shively, Christopher Baker, Muriel Steele, Donald Trunkey, Hiram C. Polk

    Research output: Contribution to journalArticle

    9 Scopus citations

    Abstract

    To evaluate the morbidity and mortality attending emergency resection of the right colon, we studied retrospectively 119 consecutive patients from two major centers, particularly examining the role of delayed anastomosis (initial ileostomy with subsequent ileocolic anastomosis). Emergency right colectomy was defined as an operative procedure in which partial resection of the terminal ileum and total or partial resection of the cecum and/or ascending colon were necessary before the colon could be evacuated and prepared as might be the case in elective resection. Ninety patients underwent primary anastomosis; hospital mortality and morbidity were 26 and 11%, respectively. Among 29 patients who underwent ileostomy, hospital mortality was 38%; hospital morbidity was 10%. In general, the patients selected for ileostomy were somewhat more ill or had more severe injury. Only 17% of all deaths and 8% of all serious complications could be attributed to the anastomosis, leaving little statistical opportunity for improvement by deleting it. The data indicate that a very high mortality (29%) attends emergency right hemicolectomy. Our study indicates that ileostomy in lieu of anastomosis does not reduce this high mortality.

    Original languageEnglish (US)
    Pages (from-to)734-739
    Number of pages6
    JournalJournal of Trauma - Injury, Infection and Critical Care
    Volume19
    Issue number10
    DOIs
    StatePublished - Oct 1979

    ASJC Scopus subject areas

    • Surgery
    • Critical Care and Intensive Care Medicine

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