title: The safety of primary repair or anastomosis in high-risk trauma patients.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Surgical Department, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece, vaglolis@otenet.gr.
authors.forename: Evangelos D
authors.initials: ED
authors.lastname: Lolis
authors.forename: Eleni
authors.initials: E
authors.lastname: Theodoridou
authors.forename: Nikistratos
authors.initials: N
authors.lastname: Vogiatzis
authors.forename: Despina
authors.initials: D
authors.lastname: Neonaki
authors.forename: Charalambos
authors.initials: C
authors.lastname: Markakis
authors.forename: Kritolaos
authors.initials: K
authors.lastname: Daskalakis
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000453:epidemiology; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007422:Intestines / Q000293:injuries* / Q000601:surgery*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome