Is colonic lavage a suitable alternative for left-sided colonic emergencies?
Anastomosis
Colon
Colonic irrigation
Colonic neoplasm
Emergency surgery
Intra-operative colonic lavage
Journal
World journal of gastrointestinal surgery
ISSN: 1948-9366
Titre abrégé: World J Gastrointest Surg
Pays: United States
ID NLM: 101532473
Informations de publication
Date de publication:
27 Apr 2021
27 Apr 2021
Historique:
received:
16
11
2020
revised:
16
02
2021
accepted:
12
03
2021
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
ppublish
Résumé
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 colectomy. To compare the peri-operative outcomes of IOCL to other procedures. Electronic databases were searched for articles employing IOCL from inception till July 13, 2020. Odds ratio and weighted mean differences (WMD) were estimated for dichotomous and continuous outcomes respectively. Single-arm meta-analysis was conducted using DerSimonian and Laird random effects. Of 28 studies were included in this meta-analysis, involving 1142 undergoing IOCL, and 634 other interventions. IOCL leads to comparable rates of wound infection when compared to Hartmann's procedure, and anastomotic leak and wound infection when compared to manual decompression. There was a decreased length of hospital stay (WMD = -7.750; 95%CI: -13.504 to -1.996; IOCL leads to similar rates of post-operative complications compared to other procedures. More extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.
Sections du résumé
BACKGROUND
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 colectomy.
AIM
OBJECTIVE
To compare the peri-operative outcomes of IOCL to other procedures.
METHODS
METHODS
Electronic databases were searched for articles employing IOCL from inception till July 13, 2020. Odds ratio and weighted mean differences (WMD) were estimated for dichotomous and continuous outcomes respectively. Single-arm meta-analysis was conducted using DerSimonian and Laird random effects.
RESULTS
RESULTS
Of 28 studies were included in this meta-analysis, involving 1142 undergoing IOCL, and 634 other interventions. IOCL leads to comparable rates of wound infection when compared to Hartmann's procedure, and anastomotic leak and wound infection when compared to manual decompression. There was a decreased length of hospital stay (WMD = -7.750; 95%CI: -13.504 to -1.996;
CONCLUSION
CONCLUSIONS
IOCL leads to similar rates of post-operative complications compared to other procedures. More extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.
Identifiants
pubmed: 33968304
doi: 10.4240/wjgs.v13.i4.379
pmc: PMC8069066
doi:
Types de publication
Journal Article
Langues
eng
Pagination
379-391Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare no conflicts of interest.
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