Objective: The aim of this study is to determine the outcomes among primary anastomosis versus colostomy in patients with penetrating colonic injuries.
Study Design: Comparative Study
Place and Duration: Study was conducted at surgical department of Mardan Medical complex, Mardan and Bakhtawar Amin Medical & Dental College, Multan for duration of one year from January, 2020 to January 2021
Methods: 70 patients were presented in this study. Patients were aged between 18-75 years. Patients details demographics age, sex and body mass index were recorded after taking informed written consent. Patients penetrating colonic injuries were admitted in emergency ward. Patients were equally (n=35) divided into 2-groups, A and B. For abdominal surgery, group A received primary anastomosis and group B received colostomy. Post-operatively outcomes and complications among both groups were identified. SPSS 22.0 version was used to analyze the data.
Results: Mean age of the patients was 29.48 ± 16.4 years with mean BMI 23.16 ± 08.13 kg/m2. Total 50 (71.43%) were males and 20 (28.57%) were females. Fire arm injured 55 (78.6%) was the most common cause of colonic injury followed by stab wound 10 (14.3%) among both groups. Small gut 28 (40%) was the most common organ injured followed by liver 13 (18.6%). Mean hospital stay in primary group was 7.45 ± 7.6 days while in colostomy group hospital stay was 9.54 ± 5.9 days. Postoperatively complications were lower in group A, wound infection found in 9 (25.71%) patients while in group B it was 11 (31.43%). Rate of mortality in primary group was 2 (5.71%) while in colostomy group was 4 (11.43%).
Conclusion: We concluded in this study that primary anastomosis was effective because of less hospital stay and less post-operatively complications as compared to colostomy. Mortality rate was higher observed in colostomy group as compared to primary.
Keywords: Colostomy, Primary anastomy, Colonic Injuries