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Is colonic lavage a suitable alternative for left-sided colonic emergencies?

World Journal of Gastrointestinal Surgery 2021年第4期13卷 379-391页

作者： Hui Yu Tham Wen Hui Lim Sneha Rajiv Jain Cheng Han Mg Snow Yunni Lin Jie Ling Xiao Fung Joon Foo Kar Yong Wong Choon Seng Chong Department of Surgery University Surgical ClusterNational University HospitalSingapore 11759Singapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore 11759Singapore Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang HealthSingapore 544886Singapore Colorectal Surgery Service Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Division of Colorectal Surgery University Surgical ClusterNational University Health SystemSingapore 119228Singapore Department of General Surgery Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore

BACKGROUND The use of intra-operative colonic lavage(IOCL)with primary anastomosis remains controversial in the emergency left-sided large bowel pathologies,with alternatives including Hartmann’s procedure,manual decompression and subtotal *** To compare the peri-operative outcomes of IOCL to other *** Electronic databases were searched for articles employing IOCL from inception till July 13,*** ratio and weighted mean differences(WMD)were estimated for dichotomous and continuous outcomes ***-arm meta-analysis was conducted using DerSimonian and Laird random *** Of 28 studies were included in this meta-analysis,involving 1142 undergoing IOCL,and 634 other *** leads to comparable rates of wound infection when compared to Hartmann’s procedure,and anastomotic leak and wound infection when compared to manual *** was a decreased length of hospital stay(WMD=-7.750;95%CI:-13.504 to-1.996;P=0.008)compared to manual decompression and an increased operating ***-arm meta-analysis found that overall mortality rates with IOCL was 4%(CI:0.03-0.05).Rates of anastomotic leak and wound infection were 3%(CI:0.02-0.04)and 12%(CI:0.09-0.16)*** IOCL leads to similar rates of post-operative complications compared to other *** extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.

关键词： Colon colonic irrigation intra-operative colonic lavage Anastomosis Emergency surgery colonic neoplasm

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