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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2003, Cilt 17, Sayı 4, Sayfa(lar) 259-265
[ Turkish ]
Our Approaches to Mechanical Colon Obstructions
Nurullah BÜLBÜLLER, Osman DOĞRU, Erhan AYGEN,Cüneyt KIRKIL, Yavuz Selim İLHAN
Fırat Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı Elazığ / TÜRKİYE
Keywords: Colon obstruction, primary anastomosis, stoma.

Mechanical colonic obstruction is a common surgical problem and challenges for diagnosis and treatment. Emergency surgery for treatment of acute colorectal obstructions have serious morbidity and mortality. One step operations with resection and primary anastomosis have been used with increasing frequency. After emergency surgery of colonic obstructions, mortality and morbidity rates are about 20% and 75% respectively. In this study, we aimed to evaluate our patients who were operated because of colonic obstructions and to determine our results.

62 patients who were operated for colon obstruction between May 1996-June 2001 in Fırat University, Medical School, Department of General Surgery were reviewed retrospectively.

In our geographic area the most common cause of colonic obstructions is sigmoid volvulus with 58% proportion (n= 36) and the second is colon tumor with 29% proportion (n= 18). Resection and anastomosis were applied electively after rectoscopic detorsion to 21 patients (33.9%) who have sigmoid volvulus. Of remaining 41 patients, emergent primary resection and anastomosis performed to 7 patients (11.3%), resection and stoma applied to 33 patients (53.2%) and removig of fecaloma to one patient (1.6%). The mortality rates are 0% for elective resection and anastomosis group, 14.3% for primary resection and anastomosis group and 24.2% for resection and stoma group. The morbidity rates are14.2% for elective resection and anastomosis group, 28.6% for primary resection and anastomosis group and 36.4% for resection and stoma group. The mortality and morbidity rates of primary resection and anastomosis group were lower than resection and stoma group.

Mortality and morbidity rates are still high in colonic obstructions. To decrease this, the etiological causes should be known before operation, a good preoperative preparation should be made and also resection + anastomosis should be prefered if it is possible.


[ Turkish ]
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