Abstract:Objective:To evaluate operative and perioperative treatment for colorectal injuries.
Methods :The clinical data of 125 patients with colorectal injuries treated over a period of 19 years were retrospectively studied.
Results:In 69 patients with perforated colon or intraperitoneal segment of the rectum, 56(81.16 %) were managed with primary repair or anastomosis, 11 cases received a colostomy, and 2 cases had "Damage control surgery". In the 18 patients with perforated extraperitoneal segment of the rectum, 14 underwent diverting colostomy of the proximal end of sigmoid with presacral drainage; 4 cases, whose wound was small and contamination was mild, received primary repair without colostomy; and the other 38 cases without full-thickness lesions of the colon and rectum were treated by simple suture. The overall mortality rate was 6.40 %(8/125); 7 patients died of hemorrhagic shock during the operation（n=6） or after the operation(n=1), and the another one died from septic complication of the thoracic cavity. The complications related with operation for colorectal trauma included local infection in 6 and intestinal obstruction in one; all of them were cured.
Conclusions:In most of the patients with injury of colon or intraperitoneal segment of rectum, primary repair or anastomosis can be carried out safely. Rational use of perioperative antibiotics, especially Metronidazole, is a necessity. Staged operation is used for injuries of extraperitoneal segment of rectum; a completely diverting proximal sigmoid colostomy should be performed, because a loop style colostomy can not interrupt contamination of the distal rectum.