Tzovaras George, Hatzitheofilou Constantine
Department of Surgery, University Hospital of Larissa, Greece.
Injury. 2005 Sep;36(9):1011-5. doi: 10.1016/j.injury.2004.11.020.
The management of colon trauma seems to have swung from the "diversion dogma" to a more liberal use of primary repair. However, there are still debatable issues, regarding the management of destructive injuries of the left colon.
A review of the current literature on the management of colon trauma was performed using PubMed, with secondary references obtained from key articles.
There is strong evidence from prospective randomised trials that the vast majority of colonic injuries can be safely managed by primary repair. It seems, however, that there is a limited role for colostomy, particularly in high-risk patients with destructive injuries of the left colon. The final decision should be based on available scientific evidence in combination with personal experience and clinical judgement on the given patient.
结肠创伤的处理方式似乎已从“转流原则”转向更广泛地采用一期修复。然而，对于左半结肠严重损伤的处理，仍存在一些有争议的问题。
使用PubMed对当前关于结肠创伤处理的文献进行综述，并从关键文章中获取二次参考文献。
前瞻性随机试验有强有力的证据表明，绝大多数结肠损伤可通过一期修复安全处理。然而，结肠造口术的作用似乎有限，尤其是在左半结肠严重损伤的高危患者中。最终决策应基于现有的科学证据，并结合个人经验以及对特定患者的临床判断。
