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Surgery Today
Published in: Surgery Today 6/2015

01-06-2015 | Original Article

The safety of primary repair or anastomosis in high-risk trauma patients

Authors: Evangelos D. Lolis, Eleni Theodoridou, Nikistratos Vogiatzis, Despina Neonaki, Charalambos Markakis, Kritolaos Daskalakis

Published in: Surgery Today | Issue 6/2015

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Abstract

Purpose

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.

Method

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.

Conclusion

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.
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Metadata
Title
The safety of primary repair or anastomosis in high-risk trauma patients
Authors
Evangelos D. Lolis
Eleni Theodoridou
Nikistratos Vogiatzis
Despina Neonaki
Charalambos Markakis
Kritolaos Daskalakis
Publication date
01-06-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-0982-5

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