Colon injuries in the presence of complete spinal cord injury: Primary repair or colostomy?

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-01-30 DOI:10.1016/j.amjsurg.2025.116225

Wei Huang , Caitlyn Braschi , Natalie Hodges , Yu Cheng Chiu , Demetrios Demetriades

{"title":"Colon injuries in the presence of complete spinal cord injury: Primary repair or colostomy?","authors":"Wei Huang , Caitlyn Braschi , Natalie Hodges , Yu Cheng Chiu , Demetrios Demetriades","doi":"10.1016/j.amjsurg.2025.116225","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Complete spinal cord injury (SCI) is associated with severe colon dysmotility and therefore may be associated with higher risk of leak following primary repair or anastomosis for concomitant colon injury.</div></div><div><h3>Methods</h3><div>TQIP database study, patients with complete SCI and associated colon injuries who underwent primary repair (PR) or resection with primary anastomosis (RPA) were compared to those who underwent ostomy alone using propensity score matching.</div></div><div><h3>Results</h3><div>Ninety-nine patients treated with a colostomy were matched with 215 treated with PR or RPA. Patients treated with colostomy were more likely to develop severe sepsis post-operatively (13.1 % vs 4.2 %, p = 0.004). Subgroup analysis, comparing colostomy versus PR or colostomy versus RPA, showed again a higher incidence of postoperative severe sepsis in the colostomy group.</div></div><div><h3>Conclusions</h3><div>Primary repair and/or RPA are associated with a lower incidence of postoperative severe sepsis than colostomy and should be considered in patients with combined SCI and colon injury.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"Article 116225"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961025000479","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Complete spinal cord injury (SCI) is associated with severe colon dysmotility and therefore may be associated with higher risk of leak following primary repair or anastomosis for concomitant colon injury.

Methods

TQIP database study, patients with complete SCI and associated colon injuries who underwent primary repair (PR) or resection with primary anastomosis (RPA) were compared to those who underwent ostomy alone using propensity score matching.

Results

Ninety-nine patients treated with a colostomy were matched with 215 treated with PR or RPA. Patients treated with colostomy were more likely to develop severe sepsis post-operatively (13.1 % vs 4.2 %, p = 0.004). Subgroup analysis, comparing colostomy versus PR or colostomy versus RPA, showed again a higher incidence of postoperative severe sepsis in the colostomy group.

Conclusions

Primary repair and/or RPA are associated with a lower incidence of postoperative severe sepsis than colostomy and should be considered in patients with combined SCI and colon injury.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.