Our Summary

The research paper is a comparison of two surgical procedures used when emergency colon surgery is considered too risky. The two procedures are Hartmann’s procedure and resection enterostomy. The researchers looked at patients who had emergency colon surgery at the University Medical Center Mannheim between 2009 and 2014.

They found that there were more repeat surgeries in the group that had the resection enterostomy procedure initially. However, there was no significant difference in terms of complications, death rate, and success in restoring the normal function of the bowel between the two groups. Overall, in about 63% of the patients who survived the surgery, normal bowel function could be restored.

The time taken for both the initial and follow-up surgeries was notably longer in the Hartmann’s procedure group. Also, five out of 13 patients in this group needed an additional procedure, protective ileostomy, during their follow-up surgery, compared to none in the other group.

The study concludes that while most patients can have their bowel function restored after emergency colon surgery, it’s still unclear which of the two procedures is the better option when the initial surgery is considered too risky.

FAQs

  1. What were the two surgical procedures compared in the study for cases when emergency colon surgery is considered risky?
  2. Was there any significant difference in terms of complications, death rate, and success in restoring normal bowel function between the Hartmann’s procedure and resection enterostomy?
  3. What were the differences found between the Hartmann’s procedure group and the resection enterostomy group in terms of time taken for surgeries and the need for additional procedures?

Doctor’s Tip

A doctor might advise a patient undergoing bowel resection to follow a healthy diet high in fiber, stay hydrated, and engage in regular physical activity to promote bowel function and prevent constipation. They may also recommend avoiding foods that can cause constipation or discomfort, such as dairy products and high-fat foods. Additionally, the patient should closely follow any post-operative instructions provided by their healthcare team and attend all follow-up appointments to monitor their recovery progress.

Suitable For

Patients who are typically recommended for bowel resection include those with conditions such as:

  • Colon cancer
  • Diverticulitis
  • Crohn’s disease
  • Ulcerative colitis
  • Bowel obstruction
  • Trauma to the colon

These conditions may require surgical intervention to remove a portion of the colon in order to alleviate symptoms, prevent complications, or treat the underlying disease. Bowel resection may be recommended when other treatments have been ineffective or when there is a risk of complications such as perforation or severe bleeding.

It is important for patients to discuss their individual case with their healthcare provider to determine the most appropriate treatment plan, including the potential need for bowel resection.

Timeline

Before bowel resection:

  1. Patient presents with symptoms that require emergency colon surgery.
  2. Doctors determine that emergency surgery is necessary.
  3. Patient undergoes either Hartmann’s procedure or resection enterostomy.
  4. Recovery period begins, including monitoring for complications and adjusting to changes in bowel function.

After bowel resection:

  1. Patients may experience pain, discomfort, and changes in bowel habits.
  2. Follow-up surgeries or additional procedures may be necessary in some cases.
  3. Patients undergo rehabilitation and support to help restore normal bowel function.
  4. Long-term follow-up is required to monitor for any complications or issues related to the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bowel resection surgery?

  2. How long is the recovery period expected to be after bowel resection surgery?

  3. Will I need a temporary or permanent colostomy or ileostomy after the surgery?

  4. What is the likelihood of needing additional surgeries or procedures following the initial bowel resection?

  5. How successful is the restoration of normal bowel function after bowel resection surgery?

  6. Are there any specific dietary or lifestyle changes I should make before or after the surgery?

  7. What is the expected length of hospital stay after bowel resection surgery?

  8. What are the long-term effects or complications that may arise from bowel resection surgery?

  9. How experienced is the surgical team in performing bowel resection procedures?

  10. Are there any alternative treatment options to consider before proceeding with bowel resection surgery?

Reference

Authors: Grott M, Horisberger K, Weiß C, Kienle P, Hardt J. Journal: Int J Colorectal Dis. 2017 Aug;32(8):1171-1177. doi: 10.1007/s00384-017-2808-6. Epub 2017 Apr 7. PMID: 28389778