Prospective study of primary repair of penetrating colonic injuries

ABSTRACT

Penetrating injuries are the most common injuries to the colon. They are the most severe and destructive injuries. These injuries were treated by different methods since the Second World War including colostomy, primary repair with exteriorization of the injured segment followed by replacement of the exteriorized segment back into the peritoneal cavity and primary repair. These methods of treatment result in different morbidity and mortality rates. Compare the results and complications of primary repair with those of faecal diversion as primary treatment of penetrating colonic injuries, including destructive injuries to the colon. [82] Cases of penetrating colonic injuries were included in the study. The patients were admitted to Al -Kindy teaching hospital during the last eight years, from 1994 to 2003. After per-operative evaluation and identification of colonic injuries were done, the patients were randomized irrespectively to the previously diagnosed risk factors into two groups, primary repair group and faecal diversion group. Five cases were excluded from the study, as they died within 24 hours from the time of injury, due to other causes not related to colonic injuries. Out of the studied 77 cases, 29 were randomized as primary repair group, 48 as faecal diversion group. The average age of primary repair group was 29.7 years while that of faecal diversion was 22.3 years. 48 cases were randomised as diversion group, 43 patients 89.58% were males and 5 patients 10% 42 were females. Male to female ratio was 8.61; 29 cases were randomised as primary repair group, 26 patients 89.65% were males and 3 patients 10.35% were females. Male to female ratio was 8.61. Septic related complications were 3 of 29 patients 10.34% in primary repair group, 13 of 48 patients 27.08% in faecal diversion group. Over all complication rates were 6 of 29 patients 20.65% for the primary repair group and 16 of 48 patients 33.32% for faecal diversion group. From that, we concluded that primary repair could be used safely as primary treatment to penetrating colonic injuries in spite of the presence of risk factors