Central Surgical Association| Volume 82, ISSUE 3, P362-365, September 1977

The exteriorized anastomosis: Its role in surgery of the colon

  • John R. Kirkpatrick
    Reprint requests: John R. Kirkpatrick, M.D., Department of Surgery, Wayne State University School of Medicine, Detroit, MI 48201.
    From the Department of Surgery, Wayne State University School of Medicine Detroit, Mich. U.S.A.

    From the Detroit General Hospital, Detroit, Mich. U.S.A.
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      Sixty-one patients (59, trauma; two, nontrauma) have been managed at Detroit General Hospital from 1972 to 1976 utilizing an exteriorized colon anastomosis. Healing of the anastomosis was present in 42 (70%) of the patients, and 37 (62%) avoided colostomy. Our experience with this procedure has demonstrated that it is a safe, reliable adjunct to be used in colon surgery when primary intraperitoneal repair is not desirable, that the added operating time (20 to 30 minutes) will not be deleterious to the patient, that the lesion is at least 18 cm above the peritoneal reflection, and that the likelihood of a prolonged septic postoperative course is not high.
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        • Kirkpatrick J.R.
        Management of colonic injuries.
        Dis Colon Rectum. 1974; 17: 319
        • Kirkpatrick J.R.
        • Rajpal S.G.
        Management of a high-risk intestinal anastomosis.
        Am J Surg. 1973; 125: 362
        • Kirkpatrick J.R.
        • Rajpal S.G.
        The injured colon: Therapeutic considerations.
        Am J Surg. 1975; 129: 187
        • Rousselot L.M.
        • Slattery J.R.
        Immediate complications of surgery of the large intestine.
        Surg Clin North Am. 1964; 44: 397
        • Schrock T.R.
        • Christensen N.
        Management of perforating injuries of the colon.
        Surg Gynec Obstet. 1972; 135: 65
        • Swinton N.W.
        Complications of colonic surgery.
        Surg Clin North Am. 1968; 48: 553
        • Vannix R.S.
        • Carter R.
        • Hinshaw D.B.
        • et al.
        Surgical management of colon trauma in civilian practice.
        Am J Surg. 1963; 106: 364