THE TERM "massive resection of the bowel" is used to denote the removal of more than one-third of the intestinal tract. The most frequent conditions necessitating excisional surgery of this magnitude are mesenteric vascular occlusion, volvulus, and strangulated hernia. Inflammatory lesions, such as regional enteritis, and neoplasms, require resection of large segments of bowel less frequently. Most massive resections are performed as emergency or semiemergency procedures on critically ill patients under less than optimal conditions, and the operative mortality is high. The morbidity among those who survive depends upon the length of bowel resected, as well as upon individual variations in bowel motility and absorption. Thus most patients who survive resection of less than 50% of the small bowel will be able to live a relatively normal life.8 When three feet or less of the small bowel remains, however, problems can be anticipated, even though the colon is intact.
THOMAS JF, JORDAN GL. Massive Resection of Small Bowel and Total Colectomy: Use of Reversed Segment. Arch Surg. 1965;90(5):781–786. doi:10.1001/archsurg.1965.01320110117019
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