Primary repair of colon injuries: clinical study of nonselective approach

BMC Gastroenterology

Research Article

Ranko G Lazovic¹  Zoran V Krivokapic²  Goran I Barisic² 

[1] Department of Abdominal Surgery, Clinical Center of Montenegro, Podgorica, Montenegro;Department of Colorectal Surgery, First surgical clinic, Clinical centre of Serbia, Belgrade, Serbia;

关键词: Anastomotic Leakage;    Primary Repair;    Stage Procedure;    Colon Injury;    Diversion Procedure;   

DOI  :  10.1186/1471-230X-10-141

 received in 2009-11-05, accepted in 2010-12-02,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThis study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach.MethodsTwo groups of patients were analyzed. Retrospective (RS) group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F) and Flint (Fl). In this group 18 patients were managed by primary repair. Prospective (PR) group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases.ResultsGroups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours). Stab wounds were more frequent in PR group (9:2), and iatrogenic lesions in RS group (6:2). Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar.In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days) deaths, with no evidence of anastomotic leakage.ConclusionsResults of this study justify more liberal use of primary repair in early management of colon injuries.Trial registrationCurrent Controlled Trials ISRCTN94682396

【 授权许可】

Unknown   
© Lazovic et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.