| Popis: |
Objective To investigate the effectiveness and safety of extraperitoneal exteriorization after repair or anastomosis of colonic injuries.Methods The clinical data of 24 cases of colonic injuries from Jan.2001 to Nov.2010 were retrospectively analyzed,including 13 males and 11 females,age from 12 to 77 with a mean of 37.4 years.The causes of colon injury were blunt trauma in 17 cases,penetrating injury in 5 cases,and iatrogenic in 2 cases.Of them 15 were admitted to our hospital directly after the injury,and the rest were transferred from other hospitals after emergency surgical management.Data on colonic injury score,incision infection,intra-abdominal abscess,colonic fistula,pulmonary infection and death rate were recorded.Results The injured region was respectively cecum,ascending colon,decending colon and sigmoid colon.Abbreviated injury scale(AIS) of colonic injuries ranged form 2 to 4(with a mean of 2.57).Multiple injuries in abdominal cavity and pelvic cavity were found in 12 patients.The time from injury to definitive operation ranged from 3 to 26(mean,9.8) hours.Twenty-three patient recovered and 1 patient died of hemorrhagic shock.Complications occurred in 5 cases(20.8%),including incision infection in 3 cases,colonic fistula in 1 case and low small intestine obstruction in 1 case.Conclusion Extra-peritoneal exteriorization of colon following repair of rapture or anastomosis is an effective and safe method in treating colonic injuries,especially in patients with delayed operation,and one-stage operation rate can be increased by this procedure. |
