FECAL DIVERSION FOR PENETRATING COLON INJURIES - STILL THE ESTABLISHED TREATMENT

被引:14
作者
RYAN, M [1 ]
DUTTA, S [1 ]
MASRI, L [1 ]
KER, R [1 ]
GOES, R [1 ]
ANTHONE, G [1 ]
ORTEGA, A [1 ]
BEART, RW [1 ]
机构
[1] UNIV SO CALIF,DEPT SURG,LOS ANGELES,CA
关键词
COLON INJURY; PENETRATING; PRIMARY REPAIR; DIVERSION; COLOSTOMY;
D O I
10.1007/BF02055599
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: An analysis of the existing literature on primary repair of colon injuries was undertaken to determine if there is sufficient evidence that this approach is superior to fecal diversion, METHODS: After a thorough Literature search, three prospectively randomized studies comparing primary repair with fecal diversion in the management of colon injuries were identified. A variety of factors were examined, including the number of patients in each study arm, morbidity rates, as well as exclusion criteria. An analysis was performed to determine the number of patients required to establish statistical superiority of one procedure over the other. RESULTS: Pooling of the data contained in the aforementioned reports does not provide sufficient statistical power to support the superiority of primary repair of colon injuries. To demonstrate a 5 percent difference between the two approaches, a prospective, randomized study consisting of 200 patients ih each arm is necessary. CONCLUSION: The present literature does not support a statistically valid advantage of primary repair over fecal diversion in the management of traumatic colon injuries.
引用
收藏
页码:264 / 267
页数:4
相关论文
共 15 条
[1]   PENETRATING COLON TRAUMA [J].
ADKINS, RB ;
ZIRKLE, PK ;
WATERHOUSE, G .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1984, 24 (06) :491-499
[2]  
BURCH JM, 1991, ARCH SURG-CHICAGO, V126, P979
[3]   MANAGEMENT OF PENETRATING COLON INJURIES - A PROSPECTIVE RANDOMIZED TRIAL [J].
CHAPPUIS, CW ;
FREY, DJ ;
DIETZEN, CD ;
PANETTA, TP ;
BUECHTER, KJ ;
COHN, I .
ANNALS OF SURGERY, 1991, 213 (05) :492-498
[4]   COLORECTAL TRAUMA - PRIMARY REPAIR OR ANASTOMOSIS WITH INTRACOLONIC BYPASS VS OSTOMY [J].
FALCONE, RE ;
WANAMAKER, SR ;
SANTANELLO, SA ;
CAREY, LC .
DISEASES OF THE COLON & RECTUM, 1992, 35 (10) :957-963
[5]   THE INJURED COLON - RELATIONSHIPS OF MANAGEMENT TO COMPLICATIONS [J].
FLINT, LM ;
VITALE, GC ;
RICHARDSON, JD ;
POLK, HC .
ANNALS OF SURGERY, 1981, 193 (05) :619-623
[6]   PRIMARY REPAIR OF COLON WOUNDS - A PROSPECTIVE TRIAL IN NONSELECTED PATIENTS [J].
GEORGE, SM ;
FABIAN, TC ;
VOELLER, GR ;
KUDSK, KA ;
MANGIANTE, EC ;
BRITT, LG .
ANNALS OF SURGERY, 1989, 209 (06) :728-734
[7]  
IVATURY RR, 1993, AM SURGEON, V59, P43
[8]  
NIELKEN N, 1989, ANN SURG, V209, P439
[9]  
OGILVIE WH, 1944, SURG GYNECOL OBSTET, V78, P225
[10]  
OSRAY CP, 1989, DIS COLON RECTUM, V32, P188