A PROSPECTIVE COMPARATIVE STUDY OF PRIMARY CLOSURE, RESECTION ANASTOMOSIS AND PRIMARY ILEOSTOMY IN PATIENTS WITH ILEAL PERFORATIONS

Dr Sasanka Nath; Dr Samir Ranjan; Dr Siddaling; Dr Shubhrojyoti Roy; Dr Suman Das

Volume : VIII, Issue : IX, September - 2019

A PROSPECTIVE COMPARATIVE STUDY OF PRIMARY CLOSURE, RESECTION ANASTOMOSIS AND PRIMARY ILEOSTOMY IN PATIENTS WITH ILEAL PERFORATIONS

Dr Sasanka Nath, Dr Samir Ranjan, Dr Siddaling, Dr Shubhrojyoti Roy, Dr Suman Das

Abstract :

Introduction: A number of studies have been undertaken to find the best surgical treatment for ileal perforation. Each modality has its own drawbacks manifested in the form of anastomotic leakages, increased morbidity and mortality. The study was to prospectively compare the outcome of primary closure, resection anastomosis, and ileostomy in cases of ileal perforations Material and methods: A total of 90 Patients meeting the inclusion criteria admitted in emergency of general surgery department were selected and placed into 3 groups depending upon the outcome of laparotomy. I.e. Primary closure; Resection anastomosis and Primary ileostomy Results: 22.2%, 31.1% and 46.7% of the patients underwent Primary closure, Resection anastomosis and Primary ileostomy respectively. Wound Dehiscence, Hypotension and Ileostomy related complications were significantly higher among the patients with Primary ileostomy (p<0.001). Fistula and Relaparotomy were higher among the patients with Resection anastomosis, but not significant (p>0.05). Conclusion: In cases where patients present within 72hrs & minimal soiling of the peritoneal cavity and healthy bowel, either primary closure or resection and anastomosis are an ideal procedure.