Fealk Michael, Osipov Robert, Foster Kevin, Caruso Daniel, Kassir Andrew
Department of General Surgery, Maricopa Integrated Health Systems, 2601 E. Roosevelt Avenue, Phoenix, AZ 85008, USA.
Am J Surg. 2004 Dec;188(6):663-70. doi: 10.1016/j.amjsurg.2004.08.057.
Surgical care in the case of traumatic injury to the colon has changed significantly. During World War II, diversion was dictum. Current trends favor primary repair.
A retrospective chart review of traumatic colon injuries at an urban level 1 trauma center was performed. Multiple data points were collected. Colon-related complications were examined in detail.
Seventy-four charts fulfilled inclusion criteria. The majority of patients were treated with primary repair. The median Colon Injury Scale (CIS) grade was 2, and the average Penetrating Abdominal Trauma Index (PATI) score was 19. Patients repaired by diversion suffered more colon-related complications; however, the difference was not statistically significant.
The emerging dictum for traumatic colon injuries is primary repair. Questions remain as to whether primary repair is the safest option for all colon injuries. The PATI score, CIS grade, and multiple other factors should be included in the decision making algorithm with an emphasis on primary repair.
结肠创伤性损伤的外科治疗已发生显著变化。在第二次世界大战期间，结肠造口术是常规做法。目前的趋势倾向于一期修复。
对一家城市一级创伤中心的创伤性结肠损伤进行回顾性病历审查。收集了多个数据点。详细检查了与结肠相关的并发症。
74份病历符合纳入标准。大多数患者接受了一期修复。结肠损伤量表（CIS）的中位数等级为2，穿透性腹部创伤指数（PATI）的平均评分为19。通过结肠造口术修复的患者出现更多与结肠相关的并发症；然而，差异无统计学意义。
创伤性结肠损伤的新常规做法是一期修复。对于所有结肠损伤，一期修复是否是最安全的选择仍存在疑问。在决策算法中应纳入PATI评分、CIS等级和其他多个因素，重点是一期修复。
