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Subcutaneous Positioning of High-Risk Colonic Anastomosis and Colonic Lesions

Arch Surg. 1986;121(8):974. doi:10.1001/archsurg.1986.01400080122025.
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To the Editor.—Primary anastomosis of unprepared colon in the presence of fecal peritonitis has a great risk of complications.1

In previous experimental work in dogs, performing colonic resections with primary anastomoses in the presence of fecal peritonitis while leaving the anastomoses in the subcutaneous tissue showed satisfactory results.2

In our service, we have operated on seven patients on an emergency basis. Three patients had perforated diverticulitis and fecal peritonitis, two patients had obstructing colonic carcinoma of the descending colon, and one patient had an iatrogenic section of the transverse colon. In all of these patients a resection with primary anastomosis was performed, positioning the colon and anastomosis subcutaneously. Another patient with impending rupture of a cecal ameboma had the inflammatory mass placed subcutaneously. In all of the patients the


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