الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acute mechanical bowel obstruction (MBO) is a common surgical emergency and a frequently encountered problem in abdominal surgery with high morbidity and mortality rates if left untreated.
Emergency surgery for acute colonic obstruction carries a significant risk of mortality and morbidity and a large number of patients will have a colostomy which is either temporary or permanent.
The emergency management of acute left-sided colonic obstruction remains controversial.
There are several treatment options which include:
(i) One-stage resection anastomosis which could be subtotal colectomy or segmental colectomy, with or without intra-operative colonic irrigation without covering stoma
(ii) Primary resection anastomosis with covering stoma (ileostomy or colostomy)
(iii) Colostomy and mucous fistula: to bring the proximal colon to surface as a colostomy and the distal bowel as mucous fistula to facilitate subsequent extra peritoneal closure
(iv) Primary resection with end colostomy (Hartmann’s operation)
(v) Simple colostomy with later resection anastomosis
(vi) Colonic stent followed later by resection anastomosis
Because of concern that the combination of a loaded proximal colon with peritoneal contamination adjacent to an anastomosis could increase the risk of anastomotic leakage, the technique of on-table colonic lavage, which was first described over a decade ago, removes the risks associated with faecal-loaded in colon proximal to an anastomosis.
In recent years there has been an increasing trend towards a single-stage procedure in the management of acute large bowel obstructions.
The purpose of this study was to evaluate the feasibility, safety and outcome of primary resection with immediate anastomosis following on-table colonic lavage for the management of acutely obstructed left colon.
This work included 25 patients presented with emergency left colon obstruction and underwent colonic lavage and immediate anastomosis between February 2014 and December 2016.
The procedure includes delivering of obstructed colon and insertion of urinary catheter into the caecum after resection of obstructed colon and performs colonic lavage by warm saline then anastomosis between two end after closure of appendicular stump.
In this study, there were no statistical significant differences between patients regarding age and sex.
Most of studied patients have cancer sigmoid (76%), and past history of diabetes mellitus (16 %) was no death or readmission.
There were minimal complications found, only 6 out of 25 patients suffered from post-operative complication, operative time ranged between 180-240 with the mean of 216.020.0 minutes. Amount of blood transfusion ranged between 1-2 liter with the mean of 1.350.43 liter.
Time of oral feeding ranged between 4-6 days with the mean of 5.240.60.The range of hospital stay was 7-10 days with a mean of 7.96±0.96 days. The period of return to normal activity was ranged from 9-13 days, with a mean of 10.78±1.31.