Evaluation of the factors contributing to the outcome of Primary repair of Colon in patients with traumatic colonic injury
Objective: The main aim of our study was to evaluate the factors contributing to the outcome of primary repair of colon in patients with traumatic colonic injury.
Study type: It is a prospective non randomized type of study.
Materials and Methods: This study was carried out in a duration of 13 months from January 2019 to February 2020 in surgical departments of Jinnah Hospital Lahore. A total of 30 patients with history of traumatic colonic injury were selected which was followed by examination and routine investigations. 24 patients were treated with primary repair while 6 were treated via staged procedure. Age, hemodynamic status, severity of injury, initial management and fecal contamination were the main outcome determining factors. Informed consent was taken from all the patients or their relatives. Hospital ethical committee approval was taken. Data was carefully recorded after close observation of patients.
Results: Among 30 selected patients with colonic injury, 24 were treated with primary repair and anastomosis of colonic injury and 6 were treated with staged procedure. Close observation was done to look for the signs of anastomotic leakage. In all these patients exploratory laparotomy was performed. 24 patients with the primary repair showed no signs of infection. 3 patients with the staged procedure expired on third post-operative day and remaining three showed signs of sepsis.
Conclusion: Age, hemodynamic status, severity of injury, initial management and fecal contamination were the main outcome determining factors. Primary repair and anastomosis in patients with clean bowel, no fecal contamination or peritonitis and with stable hemodynamic status is a better option as compared to staged procedure.Resection of damaged colon followed by primary repair in lacerated colonic injury plays important role in outcome. Devitalized tissues must be removed.
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