Wartime colon injuries: primary repair or colostomy?
A retrospective non-randomized study, comparing primary repair with colostomy, was made on a series of 102 patients with penetrating intraperitoneal colon injuries, in a war surgery programme in Cambodia. The overall case fatality rate (CFR) was 25.5%, whereas in the primary repair group CFR was 20%, compared to 30.8% in the colostomy group. The difference was not statistically significant (P = 0.30). Adjustment for possible confounding factors in the two groups did not alter the results. Considering the numerous advantages to the patient of a primary closure in the precarious situations where war surgery is often performed, this technique merits consideration.
Moreels
R
R
Médecins Sans Frontières, Brussels, Belgium.
Pont
M
M
Ean
S
S
Vitharit
M
M
Vuthy
C
C
Roy
S
S
Boelaert
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001753:Blast Injuries / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000293:injuries*; D003125:Colostomy / Q000401:mortality; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014857:Warfare; D014948:Wounds, Gunshot / Q000401:mortality / Q000601:surgery*