Complications of primary repair of colon injury: Literature review of 2,964 cases

被引:80
作者
Curran, TJ
Borzotta, AP
机构
[1] Oregon Hlth Sci Univ, Legacy Emanuel Hosp, Portland, OR 97201 USA
[2] Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA
关键词
D O I
10.1016/S0002-9610(98)00293-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
OBJECTIVE: To evaluate the safety and efficacy of primary repair of colon injuries. MATERIALS AND METHODS: A literature review was made of 35 publications containing 5,400 colon injuries in retrospective and prospective studies. RESULTS: There were 62 (2.4%) failures in 2,627 primary repairs based on surgeon discretion or absence of risk factors. In prospective series of 337 patients repaired without exclusionary criteria, there were 4 (1.2%) suture line failures (P = not significant). In prospective randomized trials without exclusionary criteria, 127 primary repairs had less morbidity compared with 109 diverted patients (P <0.02), The leak rate after resection and anastomosis (5.5%) is greater than after simple suture of perforation (1.4%; P <0.001). The 66 colon repair leaks were treated by conversion to colostomy or led to fistulae that usually healed spontaneously. A preponderance of failed repairs occurred in the setting of multiple injuries or comorbid conditions. CONCLUSIONS: Penetrating and blunt colon injuries in civilian practice are safely managed by primary repair, but colostomy may still be advised in selected cases. Am J Surg. 1999;177:42-47, (C) 1999 by Excerpta Medica, Inc.
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页码:42 / 47
页数:6
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