Penetrate injuries of colon: Our experience

In attempt to determine the place of primary repair in management of colon injuries, an open, non randomized clinical study was performed. Retrospective (RS) group of 62 patients according to exclusion criteria by Stone (S/F) and Flint (Fl) was managed by one or two stage surgical procedure. Prospective (PR) group of 34 patients was managed using one stage repair non-selectively: two stage procedures were performed in 3 cases of advanced peritonitis and multi-segmental lacerations with impaired circulation of colon. In RS group 36 patients were managed by primary repair and in PR group, 31 were managed by primary repair. Both groups were of similar age/sex. Indexes of trauma severity were similar (TS, ISS, PATI). The latent time was shorter in PR group. Associated injuries to other body regions and abdominal organs were similar in both groups. S/F criteria and Flint grading in both (RS vs. PR) groups were similar. Comparison of attempted and successful primary repairs justifies the more liberal use of primary repair in early management of colon injuries. U namjeri da utvrdimo mjesto primarne reparacije povreda kolona, uradili smo na nasem materijalu otvorenu, nerandomiziranu studiju. Retrospektivna (RS) grupa od 62 bolesnika zbrinjavana je jednostepenom ili dvostepenom procedurom, prema Fabian/Stone kriterijumima (S/F) i kriterijumima po Flintu (Fl). Prospektivna grupa (PR) sa 34 bolesnika je zbrinuta jednostepenom procedurom. Od 34 bolesnika samo kod tri su uradjene dvostepene procedure, zbog odmaklog peritonitisa i multisegmentnih laceracija sa kompromitovanom vaskularizacijom kolona. U RS grupi 36 bolesnika je zbrinuto primarnom reparacijom od 62, a u PR 31 od 34.RS i PR grupa su bile slicne polu i uzrastu. Indeksi tezine traume (TS, ISS i PATI) su bili slicni. Latentno vrijeme je bilo krace u PR grupi. Udruzene povrede ostalih tjelesnih regija i abdominalnih organa su bile slicne u RS i PR grupi. Vrijednosti S/F kriterijuma i Flintovog gradusa u obje (RS:PR) grupe su bile slicne. Uporedjivanjem postignutih rezultata opravdava se slobodnije koriscenje primarne reparacije u ranom zbrinjavanju traume kolona.