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

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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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Conflict of interest

All authors agree with the current form of this manuscript and with the opinions expressed in this manuscript. All authors agree to allow the journal to review their data if requested. There are no conflicts of interest or financial interests involved and no funding that has influenced the design, writing or decision to publish this work. All authors have disclosed any financial or personal relationships with other people or organisations that could inappropriately influence (bias) their work.

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Authors and Affiliations

  1. Surgical Department, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece

    Evangelos D. Lolis, Nikistratos Vogiatzis & Kritolaos Daskalakis

  2. Surgical Department, GPR Hospital, August-Bebel-Str. 59, 65428, Ruesselsheim, Germany

    Eleni Theodoridou

  3. Department of Anesthesiology, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece

    Despina Neonaki

  4. Intensive Care Unit, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece

    Charalambos Markakis

Authors
  1. Evangelos D. Lolis
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  2. Eleni Theodoridou
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  3. Nikistratos Vogiatzis
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  4. Despina Neonaki
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  6. Kritolaos Daskalakis
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Correspondence to Eleni Theodoridou.

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Lolis, E.D., Theodoridou, E., Vogiatzis, N. et al. The safety of primary repair or anastomosis in high-risk trauma patients. Surg Today 45, 730–739 (2015). https://doi.org/10.1007/s00595-014-0982-5

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  • DOI: https://doi.org/10.1007/s00595-014-0982-5

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