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Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience

Introduction: Attendance of patients to the emergency department due to acute large bowel obstruction is a common phenomenon. Most of these patients are elderly, critically ill, and with high comorbidity. The literature suggests that more than 50% of these cases are due to colon cancer. Since this c...

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Autores principales: Doudakmanis, Christos, Baxevanidou, Kyriaki, Chatzikomnitsa, Paraskevi, Kolla, Christina, Bouliaris, Konstantinos, Giaglaras, Anargiros, Efthimiou, Matthaios, Koukoulis, Georgios D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590149/
https://www.ncbi.nlm.nih.gov/pubmed/37868559
http://dx.doi.org/10.7759/cureus.45698
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author Doudakmanis, Christos
Baxevanidou, Kyriaki
Chatzikomnitsa, Paraskevi
Kolla, Christina
Bouliaris, Konstantinos
Giaglaras, Anargiros
Efthimiou, Matthaios
Koukoulis, Georgios D
author_facet Doudakmanis, Christos
Baxevanidou, Kyriaki
Chatzikomnitsa, Paraskevi
Kolla, Christina
Bouliaris, Konstantinos
Giaglaras, Anargiros
Efthimiou, Matthaios
Koukoulis, Georgios D
author_sort Doudakmanis, Christos
collection PubMed
description Introduction: Attendance of patients to the emergency department due to acute large bowel obstruction is a common phenomenon. Most of these patients are elderly, critically ill, and with high comorbidity. The literature suggests that more than 50% of these cases are due to colon cancer. Since this condition is considered to be an emergency, immediate intervention and response is imperative. Purpose: The aim of the present study is to present our surgical technique of colostomy formation under local anesthesia in selected critically ill patients, with increased perioperative risk and acute large bowel obstruction. Materials and methods: This is a retrospective study of 24 patients, with obstipation, who underwent emergency colostomy under local anesthesia, during the period from 2014 to 2021. Results: The mean age of the patients was 77 years. The vast majority of patients had an American Society of Anesthesiologists (ASA) score of ≥3 and a Charlson score of ≥7. The most common colostomy was transverse colostomy (21/24 patients). The patients' hospitalization ranged from four to 42 days. Only one patient died. All colostomies functioned properly in the immediate postoperative period. Only one patient required postoperative admission to the ICU. Conclusions: Colostomy under local anesthesia in critically ill, elderly patients is an alternative option for the treatment of ileus.
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spelling pubmed-105901492023-10-22 Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience Doudakmanis, Christos Baxevanidou, Kyriaki Chatzikomnitsa, Paraskevi Kolla, Christina Bouliaris, Konstantinos Giaglaras, Anargiros Efthimiou, Matthaios Koukoulis, Georgios D Cureus Emergency Medicine Introduction: Attendance of patients to the emergency department due to acute large bowel obstruction is a common phenomenon. Most of these patients are elderly, critically ill, and with high comorbidity. The literature suggests that more than 50% of these cases are due to colon cancer. Since this condition is considered to be an emergency, immediate intervention and response is imperative. Purpose: The aim of the present study is to present our surgical technique of colostomy formation under local anesthesia in selected critically ill patients, with increased perioperative risk and acute large bowel obstruction. Materials and methods: This is a retrospective study of 24 patients, with obstipation, who underwent emergency colostomy under local anesthesia, during the period from 2014 to 2021. Results: The mean age of the patients was 77 years. The vast majority of patients had an American Society of Anesthesiologists (ASA) score of ≥3 and a Charlson score of ≥7. The most common colostomy was transverse colostomy (21/24 patients). The patients' hospitalization ranged from four to 42 days. Only one patient died. All colostomies functioned properly in the immediate postoperative period. Only one patient required postoperative admission to the ICU. Conclusions: Colostomy under local anesthesia in critically ill, elderly patients is an alternative option for the treatment of ileus. Cureus 2023-09-21 /pmc/articles/PMC10590149/ /pubmed/37868559 http://dx.doi.org/10.7759/cureus.45698 Text en Copyright © 2023, Doudakmanis et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Doudakmanis, Christos
Baxevanidou, Kyriaki
Chatzikomnitsa, Paraskevi
Kolla, Christina
Bouliaris, Konstantinos
Giaglaras, Anargiros
Efthimiou, Matthaios
Koukoulis, Georgios D
Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title_full Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title_fullStr Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title_full_unstemmed Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title_short Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience
title_sort palliative treatment of bowel obstruction with colostomy under local anesthesia in frail patients: a single-site experience
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590149/
https://www.ncbi.nlm.nih.gov/pubmed/37868559
http://dx.doi.org/10.7759/cureus.45698
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