>Year 2009, Issue 4
Enríquez-Domínguez L, Díaz-Rosales JD, Arriaga-Carrera JM, Gutiérrez-Ramírez PG, Castillo-Moreno JR, Rivas-Serna J
Penetrating colon trauma: A comparison of treatments
Cir Gen 2009; 31 (4)
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Objective: To demonstrate whether it exists any difference in the results between the primary closing (resection) of the colon and colostomy in patients with penetrating trauma in colon at our hospital, and compare our results against the published results in national and international literature.
Place: Ciudad Juárez General Hospital (second level attention).
Design: Prospective and descriptive study.
Statistical analysis: Percentages as a summary measure of qualitative variables and Pearson’s chi-square test.
Patients and methods: This study included patients suffering from penetrating abdominal trauma in the period going from April 2008 to October 2009. Every patient with colon lesions was included in the study. The surviving patients were divided into two groups. Group I: patients with colostomy; and Group II: patients with primary close or resection and anastomosis.
Studied variables: Age, gender, trauma mechanism, period of time going from the lesion to the surgery, pre-surgical hemodynamic condition, duration or length of the surgery, injured site of the colon, grade of lesion, injured intraabdominal organs, established treatment, complications, days of hospital stay, and mortality.
Results: One hundred and ten patients presented colon lesions. The average age was of 28.7 years old, with a men-women rate of 10:1, 24 patients were injured by HPAB (lesions produced by cutting objects), 82 patients with lesions produced by HPAF (lesions produced by guns) and 4 patients with other lesion mechanism. The period going from the lesion and the hospitalization was of 2.8 hours, and the average time from the hospitalization to the surgery was of 1.7 hours. The length of the surgery presented an average time of 2.3 hours. The most common added lesion was in small intestine. The most affected segment was the transverse colon. The most common grade of lesion was grade II. There were no significant differences in surgical time; the days of hospital stay were of 12.9 days for Group I and of 7.2 days for Group II, with a significant difference. The post-surgical complications between both groups actually presented a significant difference. The general mortality was of 18.2%.
Conclusion: According to the number of patients in our study, we can conclude that the primary closing/resection anastomosis in patients with colon trauma is a safe management or handling that presents less morbidity in patients at Ciudad Juárez General Hospital. This procedure avoids complications related to the stoma and its secondary close, decreasing costs and improving the patients’ life quality.
||Penetrating abdominal trauma, primary closing, intestinal resection, colostomy, colon, lesions due to cutting objects, lesions produced by guns.
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>Year 2009, Issue 4