Trauma of colon and rectum: a single center experience: P082


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Abstract

Aim:Controversies still exist regarding the management of colo-rectal injuries.Method:A retrospective study of patients admitted with colo-rectal injury was performed. Different variables (demographics, injury mechanism, concomitant injuries, hemodynamic status and complications) were evaluated. Fisher's exact and Mann-Whitney tests were used for statistical analysis.Results:Fifty-eight patients were included. Sixteen patients with right-side colon injuries underwentprimary repair. Ten of them underwent right hemicolectomy. Of those, two patients developed colon-related complications (20%). In patients with left colon injury; 22 (84.6%) underwentprimary repair and four patients hadprimary repair withprotective colostomy. Three patients (13.6%) developed anastomotic leakage. Hemodynamic instability and damage controlprocedure were found to be independent risk factors for anastomotic leakage (P = 0.032, P = 0.019). Twelve of 16 patients with rectal injuries underwent diverting sigmoidostomy (primary repair in four patients). Four patients had apre-sacral drainage. Rectal washout was performed in one patient. No complications were observed.Conclusion:Primary repair of colonic injuries is safe. Colostomy should be considered in patients with signs of hemodynamic instability and in damage controlprocedure. Protective colostomy is recommended in most patients with rectal injury. Distal washout andpre-sacral drainage are not necessarily required.

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