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International Journal of Colorectal Disease

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01-09-2009 | Original Article

Systematic review of intraoperative colonic irrigation vs. manual decompression in obstructed left-sided colorectal emergencies

Authors: MH Kam, CL Tang, E Chan, JF Lim, KW Eu

Published in: International Journal of Colorectal Disease | Issue 9/2009

Abstract

Aims

A systematic review was conducted to determine if manual decompression is a safe alternative to intraoperative colonic irrigation prior to primary anastomosis in obstructed left-sided colorectal emergencies.

Methods

Search for relevant articles from 1980 to 2007 was conducted on Medline, Embase and the Cochrane Controlled Trials Register using the keywords “colonic lavage, irrigation, decompression, washout, obstructed and bowel preparation”, either singularly or in combination. Trials in English publications with similar patient characteristics, inclusion criteria and outcome measures were selected for analysis. Thirty-day mortality, anastomotic leak rates and post-operative wound infection were studied as outcome variables. Analysis was performed with RevMan 4.2 software.

Results

Seven trials were identified for systematic review, with a total of 449 patients. Data from the single randomised controlled trial and one prospective comparative trial were analysed separately. Results from the remaining five studies were pooled into two arms of a composite series, one with colonic irrigation and one without. Results showed no significant difference in the anastomotic leak rates and mortality rates between the colonic irrigation and manual decompression arms in the randomised and comparative trials. The composite series, however, showed significantly better results with manual decompression (RR 6.18, 95% CI 1.67–22.86). The post-operative infection rate was similar in both groups.

Conclusion

Manual decompression was comparable to colonic irrigation for primary anastomosis in obstructed left-sided colorectal emergencies, with no significant increase in mortality, leak or infection rates.

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Title: Systematic review of intraoperative colonic irrigation vs. manual decompression in obstructed left-sided colorectal emergencies
Authors: MH Kam
CL Tang
E Chan
JF Lim
KW Eu
Publication date: 01-09-2009
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 9/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-009-0723-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Systematic review of intraoperative colonic irrigation vs. manual decompression in obstructed left-sided colorectal emergencies

Abstract

Aims

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Aims

Methods

Results

Conclusion

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