title: Rectal perforations. Personal experience and literature review.
abstract: BACKGROUND
  Rectal perforation presents high morbidity and mortality and its treatment is still not standardized, it is still rather based on the surgeon's personal experience. This retrospective trial, with a literature review, aims to define these types of lesions, and tries to identify the diagnostic and therapeutic options able to reduce related morbidity and mortality.
  
  
  METHODS
  On 1175 operations conducted for colo-rectal emergency, over a ten-year period at our institution, fourteen consecutive patients (1.2%) were seen and treated for rectal perforation. In 43% of cases the treatment consisted in Hartmann's procedure, in the 28.5% ones in rectal wound repair with diverting colostomy and in 28.5% left in diverting colostomy alone.
  
  
  RESULTS
  There were no postoperative complications in 86% of patients, and no deaths from sepsis. In 28.5% of cases intestinal continuity was restored at our institution.
  
  
  CONCLUSIONS
  Our results demonstrate that a standardized protocol which is based on patients' conditions, type and degree of rectal injury and of peritonitis, must be followed in order to determine the type of surgical option and consequently to reduce the morbidity and mortality related to rectal perforation.
authors.affiliation: Section of General Surgery, Vascular Surgery and Clinical Oncology, Department of Applications in Surgery of Innovative Technologies, University of the Study, Bari, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Di Venere
authors.forename: M
authors.initials: M
authors.lastname: Testini
authors.forename: S
authors.initials: S
authors.lastname: Miniello
authors.forename: G
authors.initials: G
authors.lastname: Piccinni
authors.forename: G
authors.initials: G
authors.lastname: Lissidini
authors.forename: F
authors.initials: F
authors.lastname: Carbone
authors.forename: G M
authors.initials: GM
authors.lastname: Bonomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003125:Colostomy; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*; D016896:Treatment Outcome