S Saar1, D McPherson2, A Nicol2, S Edu2, P Talving3, P Navsaria2. 1. Division of Acute Care Surgery, North Estonia Medical Centre, Tallinn, Estonia; University of Tartu, Tartu, Estonia. Electronic address: stensaars@gmail.com. 2. Trauma Unit, Groote Schuur Hospital, Cape Town, South Africa. 3. University of Tartu, Tartu, Estonia; Administration, North Estonia Medical Centre, Tallinn, Estonia.
Abstract
BACKGROUND: Management of colon injuries has significantly evolved in the recent decades resulting in considerably decreased morbidity and mortality. We set out to investigate penetrating colon injuries in a high-volume urban academic trauma center in South Africa. METHODS: All patients with penetrating colon injuries admitted between 1/2015 and 1/2018 were prospectively enrolled. Data collection included demographics, injury profile and outcomes. Primary outcome was in-hospital mortality. Secondary outcome was morbidity. RESULTS: Two-hundred and five patients were included in the analysis. Stab and gunshot wounds constituted 18% and 82% of the cases, respectively. Mean age was 28.9 (10.2) years and 96.1% were male. Median injury severity score (ISS) and penetrating abdominal trauma index (PATI) were 16 (9-25) and 19 (10-26), respectively. A total of 47.8% of the patients had a complication per Clavien-Dindo classification. Colon leak rate was 2.4%. Wound and abdominal organ/space infection rate was 15.1 and 6.3%, respectively. Overall in-hospital mortality was 9.3%. Risk factors for mortality were higher ISS and PATI, shock on admission, need for blood transfusion, intra-abdominal vascular injury, damage control surgery, and extra-abdominal severe injuries. CONCLUSIONS: Contemporary overall complication rate remains high in penetrating colon injuries, however, anastomotic leak rate is decreasing. Colon injury associated mortality is related to overall injury burden and hemorrhage rather than to colon injuries.
BACKGROUND: Management of colon injuries has significantly evolved in the recent decades resulting in considerably decreased morbidity and mortality. We set out to investigate penetrating colon injuries in a high-volume urban academic trauma center in South Africa. METHODS: All patients with penetrating colon injuries admitted between 1/2015 and 1/2018 were prospectively enrolled. Data collection included demographics, injury profile and outcomes. Primary outcome was in-hospital mortality. Secondary outcome was morbidity. RESULTS: Two-hundred and five patients were included in the analysis. Stab and gunshot wounds constituted 18% and 82% of the cases, respectively. Mean age was 28.9 (10.2) years and 96.1% were male. Median injury severity score (ISS) and penetrating abdominal trauma index (PATI) were 16 (9-25) and 19 (10-26), respectively. A total of 47.8% of the patients had a complication per Clavien-Dindo classification. Colon leak rate was 2.4%. Wound and abdominal organ/space infection rate was 15.1 and 6.3%, respectively. Overall in-hospital mortality was 9.3%. Risk factors for mortality were higher ISS and PATI, shock on admission, need for blood transfusion, intra-abdominal vascular injury, damage control surgery, and extra-abdominal severe injuries. CONCLUSIONS: Contemporary overall complication rate remains high in penetrating colon injuries, however, anastomotic leak rate is decreasing. Colon injury associated mortality is related to overall injury burden and hemorrhage rather than to colon injuries.
Authors: G V Oosthuizen; S R Čačala; V Y Kong; D Couch; J Buitendag; S Variawa; N Allen; D L Clarke Journal: World J Surg Date: 2021-09-29 Impact factor: 3.352
Authors: Luke Smyth; Cino Bendinelli; Nicholas Lee; Matthew G Reeds; Eu Jhin Loh; Francesco Amico; Zsolt J Balogh; Salomone Di Saverio; Dieter Weber; Richard Peter Ten Broek; Fikri M Abu-Zidan; Giampiero Campanelli; Solomon Gurmu Beka; Massimo Chiarugi; Vishal G Shelat; Edward Tan; Ernest Moore; Luigi Bonavina; Rifat Latifi; Andreas Hecker; Jim Khan; Raul Coimbra; Giovanni D Tebala; Kjetil Søreide; Imtiaz Wani; Kenji Inaba; Andrew W Kirkpatrick; Kaoru Koike; Gabriele Sganga; Walter L Biffl; Osvaldo Chiara; Thomas M Scalea; Gustavo P Fraga; Andrew B Peitzman; Fausto Catena Journal: World J Emerg Surg Date: 2022-03-04 Impact factor: 5.469