PURPOSE: There is currently not enough data regarding the management of bowel injury and the results of primary repair or resection and anastomosis in high-risk trauma patients. We aimed to determine whether there were any short-term (30 days) postoperative complications relevant to the primary reconstruction of such bowel injuries. METHOD: In a retrospective study, all trauma patients who underwent a definite laparotomy after penetrating or blunt injury in our institution during the last decade were identified. The study group consisted of those who underwent primary repair or resection and anastomosis of the small or large bowel or both. Patients who died within 72 h of admission, who had only serosal injuries or who received resection and diversion, were excluded. RESULTS: Seventeen of the trauma patients who were treated at our institution during the study period had bowel injuries. Thirteen fit our criteria. All of them had at least one risk factor, and 61.5% of them had at least three risk factors for anastomotic or suture line disruption. Overall, 35 repairs and anastomoses took place. Only one patient developed clinical anastomotic leakage, resulting in a fistula, which did not require re-operation. CONCLUSION: Our study contributes to the controversial issue of post-traumatic bowel reconstruction in high-risk trauma patients, and suggests that primary reconstruction is feasible and can provide a good outcome.
PURPOSE: There is currently not enough data regarding the management of bowel injury and the results of primary repair or resection and anastomosis in high-risk traumapatients. We aimed to determine whether there were any short-term (30 days) postoperative complications relevant to the primary reconstruction of such bowel injuries. METHOD: In a retrospective study, all traumapatients who underwent a definite laparotomy after penetrating or blunt injury in our institution during the last decade were identified. The study group consisted of those who underwent primary repair or resection and anastomosis of the small or large bowel or both. Patients who died within 72 h of admission, who had only serosal injuries or who received resection and diversion, were excluded. RESULTS: Seventeen of the traumapatients who were treated at our institution during the study period had bowel injuries. Thirteen fit our criteria. All of them had at least one risk factor, and 61.5% of them had at least three risk factors for anastomotic or suture line disruption. Overall, 35 repairs and anastomoses took place. Only one patient developed clinical anastomotic leakage, resulting in a fistula, which did not require re-operation. CONCLUSION: Our study contributes to the controversial issue of post-traumatic bowel reconstruction in high-risk traumapatients, and suggests that primary reconstruction is feasible and can provide a good outcome.
Authors: Mickey M Ott; Patrick R Norris; Jose J Diaz; Bryan R Collier; Judith M Jenkins; Oliver L Gunter; John A Morris Journal: J Trauma Date: 2011-03
Authors: Carlos A Ordoñez; Luis F Pino; Marisol Badiel; Alvaro I Sánchez; Jhon Loaiza; Leonardo Ballestas; Juan Carlos Puyana Journal: J Trauma Date: 2011-12
Authors: D Demetriades; J A Murray; L Chan; C Ordoñez; D Bowley; K K Nagy; E E Cornwell; G C Velmahos; N Muñoz; C Hatzitheofilou; C W Schwab; A Rodriguez; C Cornejo; K A Davis; N Namias; D H Wisner; R R Ivatury; E E Moore; J A Acosta; K I Maull; M H Thomason; D A Spain Journal: J Trauma Date: 2001-05
Authors: Tanya Zakrison; Bartolomeu A Nascimento; Lorraine N Tremblay; Alex Kiss; Sandro B Rizoli Journal: World J Surg Date: 2007-08 Impact factor: 3.352