Feasibility of colonic exteriorization with repair of the posterior wall of the colon as a single stomal site after emergency colectomy

BACKGROUND: Emergency colectomy although it is a common surgical procedure but no consensus between surgeons about to anastomose or not and with or without diversion as the surgeon should balance between the risk of leak and having a temporary stoma. The aim of this study was to assess our technique exteriorization after repair of the posterior wall as a single stoma after emergency colectomy. METHODS: This cohort included 103 patients with emergent colectomy 10 were excluded the remaining 93 patients were (obstructed colon cancer, volvulus sigmoid, sigmoid diverticulitis, strangulated hernia, trauma). The colonic segment with the pathology was resected and the posterior wall of the colon was repaired leaving the anterior wall unrepaired. RESULTS: Among the 93 patients who were operated with our technique the mean hospital stay was 5 +/- 1.6 day with a mean operative time 147 +/- 45 min. One patient developed retraction of the distal end of colostomy by the third postoperative day. On reversal of colostomy, two patients had developed leak, one was managed conservatively and the other was reversed to Hartmann's procedure. CONCLUSIONS: Exteriorization after repair of the posterior colonic wall during emergency colectomy when feasible provides a safe, rapid, and simple alternative procedure specially in elderly frail patients with comorbidities.