Primary Anastomosis vs Creation of Stoma without Anastomosis in Surgical Management of Acute Intestinal Obstruction: A Cross-sectional Study

Introduction: The surgical management of Acute Intestinal Obstruction (AIO) may require resection of non viable gut in presence of strangulated bowel. After gut resection, the surgeon has to choose between a primary anastomosis and a creation of stoma only without anastomosis, to attain an uneventful recovery. Aim: To evaluate and compare the early postoperative outcome of patients of AIO treated with either primary anastomosis or with stoma only, without anastomosis following intestinal resection and to identify the factors associated with postoperative morbidity and mortality in both groups of patients. Materials and Methods: A cross-sectional study was conducted from July 2018 to June 2019 in a teaching hospital with tertiary care facility, on first 100 adult patients of AIO treated surgically within the study period with either primary anastomosis or with stoma formation only following gut resection. Patients undergoing primary anastomosis were placed in Group A (N=48) while patients undergoing stoma formation only were placed in Group B (N=52). Preoperative and postoperative data were collected and final outcome within the first two weeks of postsurgery was noted. The primary outcome was postoperative recovery or death of the treated patients. The secondary outcome was determined using parameters like time taken to resume oral diet, time of discharge from hospital and presence of postoperative complications in both groups of patients. Chi-square test and Mann-Whitney U tests were applied using confidence interval of 95% and p-value