A comparative study between right hemicolectomy with ileotransverse anastomosis and primary repair with or without ileostomy/Colostomy in the management of Caecal perforation

Abstract

Background: Study was conducted in the Department of General Surgery, Index Medical College and Hospital, Indore from May 2013 to April 2016 (Three Years), 100 patients admitted to surgical emergency with acute abdomen were selected for the study. Method: Comparative study was done between group A (right hemicolectomy with ileotransverse anastomosis) and group B (primary repair with omental patch, primary repair with defunctioning loop ileostomy, Right hemicolectomy with double barrel ileo-transverse colostomy). There was no selection criteria for patients. Result: We found (76%) males and the females (24%) in our study, there was statistical significance in wound infection/serous discharge between group A and group B with p value=0.047, there was statistical insignificance found in between group A and group B with p value=0.043 in anastomotic leak/ fistula, There was statistical significance found in outcome between group A and group B with p value=0.028 Conclusion: Right hemicolectomy with ileotransverse anastomosis in cases of traumatic caecal perforation plays an important role in reducing the incidence of complications like wound infection, wound dehiscenes, ileostomy and colostomy related complications like weight loss and electrolyte imbalance. We recommend that Right hemicolectomy with ileotransverse anastomosis should be preferred over other surgical options, primary repair with omental patch, primary repair with defunctioning loop ileostomy, Right hemicolectomy with double barrel ileo-transverse colostomy in cases of caecal perforations in randomised study.