Ileocecectomy as an Acceptable Alternative to Right Hemicolectomy in Trauma: A Propensity Score Matched TQIP Analysis.

IF 1 4区医学 Q3 SURGERY

American Surgeon Pub Date : 2025-08-01 Epub Date: 2025-03-01 DOI:10.1177/00031348251323699

Devanshi D Patel, Andrew M Fleming, Andrew J Kerwin, Cory Evans, Emily K Lenart, Dina M Filiberto, Saskya Byerly

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引用次数: 0

Abstract

BackgroundIleocecectomy (IC) as an alternative to right hemicolectomy (RH) for traumatic indication is controversial with limited comparison data. We sought to compare IC vs RH for traumatic injury and hypothesized there was no difference in outcomes.MethodsThe Trauma Quality Improvement Program database was queried from 2017 to 2022 with IC and RH patients evaluated using propensity score matching (PSM) in a 1:3 ratio. Presenting factors and outcomes were analyzed.ResultsAfter PSM, 558 RH and 186 IC patients had no difference in age, penetrating mechanism, time to OR and injury severity score. RH patients were more likely to have unplanned ICU admission (8.6% vs 3.8%, P = 0.03) and organ space infection (7.5% vs 3.2%, P = 0.04) but similar rates of acute kidney injury (P = 0.5), unplanned OR (P > 0.9) and mortality (P = 0.08) compared to IC patients.ConclusionsTraumatic colon injury managed by ileocecectomy had similar outcomes compared to right hemicolectomy and should be considered an acceptable alternative when anatomically feasible.

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回肠切除术作为创伤中右半结肠切除术的可接受选择：倾向评分匹配TQIP分析。

背景：回肠切除术（IC）作为替代右半结肠切除术（RH）创伤指征是有争议的，有限的比较数据。我们试图比较IC和RH治疗外伤性损伤，并假设结果没有差异。方法：查询2017年至2022年创伤质量改善计划数据库，使用倾向评分匹配（PSM）以1:3的比例对IC和RH患者进行评估。分析表现因素及结果。结果：558例RH患者与186例IC患者经PSM后，在年龄、穿透机制、到OR时间及损伤严重程度评分上无差异。RH患者更有可能出现计划外ICU入院（8.6% vs 3.8%, P = 0.03）和器官空间感染（7.5% vs 3.2%, P = 0.04），但与IC患者相比，急性肾损伤（P = 0.5）、计划外OR （P = 0.90）和死亡率（P = 0.08）的发生率相似。结论：与右半结肠切除术相比，回肠切除术治疗外伤性结肠损伤的结果相似，在解剖学上可行时应被视为可接受的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Surgeon 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

623

期刊介绍： The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.