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KMID : 0371319670090020089
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Journal of the Korean Surgical Society
1967 Volume.9 No. 2 p.89 ~ p.94
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Surgical Management of Colon Injuries
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裵柄源/Bae, Byung Won
李康勳/玄九源/金垠燮/Lee, Gang Hoon/Hyun, Koo Won/Kim, Un Sup
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Abstract
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1) 44 cases of colon injury are reported, of which primary closure was carried out on 28 cases and exteriorization procedures on 16 cases.
2) No well-delineated relationship could be seen between lag peried from the time of injurry to, definite surgery and mortality, and complication rate. However, mortality sharply increases when operated on later than 18 hours after the injury.
3) The degree of gross peritoneal contamination at the time of surgery and preoperative systemic manifestation of peritonitis as well as physical findings were the most important criteria in the selection of patients for primary closure. During the proccedure, the peritoneal cavity was irrigated with 0.25% neomycin sulution sulfate solution.
4) Comlication and morbidity rates were higher in cases for which exteriorization procedure was carried out than for cases in which primary closure was carried out (18.70% vs 10.7%). The higher complication rate following exteriorization procedure seemed to be largely due to multiplicity of injury, higher incidence and extensiveness of associated injuries in cases for which exteriorization procedure had to be carried out.
5) Average days of hospital stay of the exteriorization groups was almost 2 times that of primary procedure groups, and it is proposed that in selected cases of colon injuries, primary closure can be carried out with impunity, thus reducing the days of hospital stay and providing better
psychological balance.
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