Background: Penetrating colon injuries treatment has been a controversial topic of discussion in medical literature. The literature shows that randomized trials comparing primary repair versus bypass showed no significant difference in complication rates between the two groups. While other trials comparing complication rates between the two groups showed that the primary repair has lower complication rates as compared to the colostomy. Methodology: Randomized control trail was conducted in six months of duration from 1stJanuary 2020 to 31stDecember 2020in surgical unit of DHQ Teaching Hospital / SMC (UOS), Sargodha. After taking Ethical approval from the hospital, the study was conducted on 300 patients sample size calculated through open Epi sample size calculator with margin of error 5% and confidence interval 95%. Randomized blotting technique was used for randomization to overcome biasness.

Results: Group 01 of primary anastomosis had 97 (64.67%) males and 53 (35.33%) females while group 02 of colostomy had 92 (66.34%) males and 58 (33.66%) females. complications intra-abdominal abscess was analyzed between both groups. In group 01 primary anastomosis, only 4 (2.66%) patients develop intra-abdominal abscess while in rest of patients i.e. 146(97.34%) showed efficacy to primary anastomosis. In group 02 of colostomy, 27 (18%) patients develop intra-abdominal abscess while rest of patients i.e. 123(82%) patients showed efficacy towards colostomy.

Conclusion: In penetrating colon injuries, anastomosis showed more efficacy, safe to use and excellent results on the basis of post-operative complications as compared to colostomy.

Keywords: Primary anastomosis, defunctioning in colostomy, penetrating colonic injuries, effectiveness