Naraynsingh V, Ariyanayagam D, Pooran S
Department of Surgery, General Hospital, Port of Spain, Trinidad, West Indies.
Br J Surg. 1991 Mar;78(3):319-20. doi: 10.1002/bjs.1800780317.
Because there are several specific disadvantages to a colostomy in a developing country, primary repair for colon injury was electively performed. Sixty-one consecutive patients with colon injury were seen between 1978 and 1989 and 57 of these (93 per cent) underwent primary repair. In four a colostomy was constructed. Emergency repair was carried out regardless of site or mode of injury, presence of hypotension or peritoneal contamination. There was one death unrelated to anastomotic complications and one anastomotic leakage. The faecal fistula closed spontaneously in 4 weeks. The wound infection rate was 10 per cent. These data support the emerging view that primary repair of colon injury is the management of choice.
由于在发展中国家进行结肠造口术存在一些特定的不利因素,因此我们选择性地对结肠损伤进行一期修复。1978年至1989年间,我们连续观察了61例结肠损伤患者,其中57例(93%)接受了一期修复,4例进行了结肠造口术。无论损伤部位、损伤方式、是否存在低血压或腹腔污染,均进行急诊修复。有1例死亡与吻合口并发症无关,1例发生吻合口漏。粪瘘在4周内自行闭合。伤口感染率为10%。这些数据支持了新出现的观点,即结肠损伤的一期修复是首选的治疗方法。