Choice of access for urgent and emergency operations on the colon

Introduction: the purpose of this work was to study the immediate results of treatment and develop an algorithm for using different access options for urgent colon operations. Material and methods: the study performed a retrospective analysis of the results of treatment of 89 patients with various diseases of the colon, operated on urgently and urgently. All patients were divided into 2 groups: 31 patients (the main group) - operated from laparoscopic access, 58 patients (the comparison group) - from laparotomic access. The groups were comparable in age, frequency, and type of underlying and concomitant diseases, but differed in gender, risk class of anesthesia (ASA), and incidence of complications of the underlying disease. Results: the main indications for emergency or urgent surgery were acute intestinal obstruction (16.2% vs. 53.5%), intestinal bleeding (41.9% vs. 6.9%) and peritonitis (22.6% vs. 29.3%). The average duration of operations did not depend on the type of access used. There were no significant differences in the frequency of postoperative complications between patients of both groups (9.7% vs. 6.9%). The use of laparoscopic access resulted in a statistically significant reduction in the recovery time of intestinal peristalsis (2.1±0.4 vs. 3.8±0.9 days), and was accompanied by a significant reduction in the time of use of analgesics (2.7±0.6 vs. 4.6±1.2 days). Conclusion: the use of laparoscopic approach for urgent diseases of the colon does not increase the duration of interventions and frequency of postoperative complications, but is accompanied by a shortening of postoperative intestinal paresis and reduced need for analgesics. The developed algorithm for selecting surgical access allows increasing the number of patients with urgent colon diseases who can be operated minimally invasive.