In Right Colon Gunshot Injuries, Resection and Anastomosis Versus Primary Repair

Authors

  • Salah Mansor General Surgery Department Al-Jalaa Teaching Hospital, Benghazi University
  • Monir Alfitory Al-Jalaa Teaching Hospital, Benghazi University
  • Ahmed Algialany Al-Jalaa Teaching Hospital, Benghazi University
  • Ayoop Buzaja Al-Jalaa Teaching Hospital, Benghazi University
  • Ahmed Eltarhoni Department of Family and community Medicine, Benghazi University

Keywords:

Ascending Colon, Simple Repair, Hemicolectomy, Anastomotic Leak

Abstract

In case of ascending colon injuries, the predominant procedures are right hemicolectomy, ileocecal resection, and simple repair. The study has prospectively compared patients who have had right colon resection, with those who have had a simple repair due to gunshot injuries, to analyses the differences between both procedures in terms of post-operative outcomes. A cohort study was used to compare patients who had right colon resection, and patients who had a simple repair, to analyses the influence of the operative procedure on the short-term post-operative outcomes in all patients who had undergone urgent laparotomies following gunshot injuries to the right colon. This occurred during the time period from February 17, 2011 to December 31, 2018, in our department. Out of 65 patients, 63 (97%) were male and 2 (3%) were female, with a mean age of 29.3 years old. 43 (66.2%) patients had right colon resection and anastomosis, while 22 (33.8%) patients were treated by simple repair. Upon admission, 38 (58.5%) patients were in shock, 48 (73.8%) cases had faecal contamination, and 46 (70.8%) suffered from a multi-organ injury. According to the colon injury scale, in grade I there were 3 (4.6%) cases; while grade II, III, IV, V had 9 (13.8%), 35 (53.8%), 10 (15.4%) and 8 (12.3%) cases, respectively. The duration from the injury to the operation was less than 200 minutes in all cases. We have concluded that, in ascending colon injuries, there was no advantage of the simple repair over the hemicolectomy; therefore, it was not feasible to consider it as an acceptable safe alternative procedure.

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Published

2021-12-19

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