Over time, the concept of a one-stage resection with intraoperative colonic lavage and primary anastomosis evolved as a potential surgical alternative to subtotal colectomy.
More recent studies have described implementation of Dudley et al.'s technique for on-table antegrade colonic lavage, with only slight modification of the catheter location (through the appendix, terminal ileum, or cecum) to deliver irrigation and decrease fecal load proximal to the obstructing lesion in preparation for a primary anastomosis.
Increasing stool volumes with regular oral fibre supplementation, together with oral laxatives such as senna preparations given the night before combined with either manual removal, a mini-enema or in well-trained/ experienced patients a
colonic lavage (such as Coloplast) are key ingredients of an effective flaccid bowel management programme.