Tripathi Munishwar D, Mishra Brijesh
Department of Surgery, L.L.R.M. Medical College, Meerut, India.
Int Surg. 2005 Nov-Dec;90(5):297-304.
This paper compares the outcome of colonic injuries (primary repair and proximal colostomy) in 94 cases. It concludes that certain risk factors are of predictive value in case of colon injuries (eg, gross fecal contamination, more than two visceral injuries, more than four units of blood transfusion, and extensive colonic injuries) irrespective of type of operation performed. Primary repair is debatable; however, in the present antibiotic era, it is safe and less costly than the two-stage procedure of proximal colostomy with repair. Primary repair can be performed in almost all cases except in certain selected cases that are decided on the table, taking into account the above risks factors. Mortality in cases of colonic injuries is associated with risk factors rather than colonic injury itself.
本文比较了94例结肠损伤（一期修复和近端结肠造口术）的治疗结果。研究得出结论，无论采用何种手术方式，某些危险因素在结肠损伤病例中具有预测价值（例如，严重粪便污染、超过两处内脏损伤、超过四个单位的输血以及广泛的结肠损伤）。一期修复存在争议；然而，在当前的抗生素时代，它比近端结肠造口术加修复的两阶段手术更安全且成本更低。除了某些根据上述危险因素在手术台上决定的特定病例外，几乎所有病例都可以进行一期修复。结肠损伤病例的死亡率与危险因素相关，而非结肠损伤本身。
