Surgical approach for colon perforation and traumatic ruptures at the multifield hospital

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OBJECTIVE

To analyze postoperative outcomes in patients with colon perforation and traumatic ruptures at the multifield hospital.

MATERIAL AND METHODS/

The study included 93 patients aged 24—85 years with colon perforation and traumatic ruptures. All patients were divided into 3 groups depending on the cause of colon perforation: group 1 — 43 (46.2%) patients with colon cancer, group 2 — 27 (29%) patients with ulcerative colitis, group 3 — 22 (23.6%) patients with traumatic ruptures following blunt abdominal trauma. Cause of colon perforation was unclear in 1 (1.1%) case. Diagnostic algorithm included routine clinical and laboratory methods and modern minimally invasive endoscopic surgical technologies (ultrasound, CT, MRI, colonoscopy, laparoscopy).

RESULTS/

Ninety (96.8%) out of 93 patients with colon perforation underwent surgery. Postoperative mortality was 41.5%, 46.1% and 31.8% in all groups, respectively. Overall postoperative mortality was 40%.

CONCLUSION

Bowel resection with colostomy is preferred for colon perforation regardless the cause of injury because this procedure ensures the best immediate results. Palliative suturing of perforations with colostomy or delivering the affected colon segment on anterior abdominal wall are accompanied by high mortality and should be used for strict indications in severely ill patients.

Keywords:

colon perforation

colon cancer

ulcerative colitis

traumatic rupture of the colon

surgical strategy

suturing

colostomy

hemicolectomy

colectomy

mortality

Authors:

Aliev S.A.

Azerbaijan Medical University

Aliev É.S.

Azerbaijan Medical University

Received:

10.02.2021

Accepted:

17.03.2021

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