대한대장항문학회

Staged procedures are preferred to single stage procedures in emergency based left colonic obstruction or perforation because of the safety. <b>Purpose:</b> To evaluate whether the single stage procedure in emergency based left colonic pathology<br>is<br>not<br>safe. <b>Methods:</b> We compared medical records of single stage procedure (SP, n=22 male; 10, mean age: 60±17, range: 26∼82 Yrs) with Hartmanns procedure (HP, n=23 male; 13, mean age: 58±16, range: 18∼90 Yrs) and diverting loop colostomy<br>(DC,<br>n=19, male; 12, mean age: 59±19, range: 19∼80 Yrs) in these 4 years. All the patients were admitted via emergency room. Intraoperative colonic irrigation method with newly developed irrigation device (MITech co., Ltd, Seoul, Korea) was used for<br>SP.<br>APACHE Ⅲ scoring system was applied to evaluate the physiologic status of the patients. Preoperative data were compared with the 1st and 3rd postoperative day (POD). <b>Results:</b> There were no statistically significant differences in patient<br>demographics and preoperative APACHE Ⅲ scores. The improvement of APACHE Ⅲ score was significant in SP and DC on the 3rd POD from 29.6±20.9 to 22.9±10.2 and 25.7±13.3 to 21.4±14.8 (P<0.05). There was also a significant improvement in DC<br>(25.7±13.3 to 21.9±12.9, P<0.05) on the 1st POD, however, there was only a tendency of improvement in SP (29.6±20.9 to 26.1±12.3) without statistical significance. The scores in HP showed no improvement on the 1st and 3rd POD. There were 3<br>operative<br>mortalities in HP and one in DC. <b>Conclusions:</b> Our results suggest that the safety of the single stage procedure with newly developed colonic irrigation device is comparable to palliative decompressive loop colostomy and better than<br>Hartmanns<br>procedure in emergency based left colonic pathology.<br>