Kolon yaralanmalarında cerrahi tedavi

Abstract

-24- ÖZET 1980 - 1989 tarihleri arasındaki 10 yıllık sürede tedavi edilen 191 olgu retrospektif olarak incelenmiş ve cerrahi girişim sonuçları değerlendirilmiştir. %94 erkek o lan olguların yaş ortalaması %28,5 idi. Travma etkeni bü yük çoğunlukta (%94) penetran batın yaralanması idi. Olguların %33'ü 6 saatten geç hastaneye baş vurmuş olup, %25 olguda baş vuru anında hipovolemik şok mevcuttu, 146 olguda 296 yandaş travma eşlik ederken, 45 olguda (%23,56) sadece kolon yaralanmıştı. Olgularda %68.5 oranında primer tamir, %31.5 kolos- tomi uygulanmıştır. Sağ kolon yaralanmalarında primer tamir oranı %95.6 iken Transvers kolonda %72.3, sol kolon yaralan malarında bu oran %42.39 idi. Mortalite %15.7 bulunmuş ve mortaliteye etki eden faktörlerin, yandaş travma sayısı (p < 0.05), gecikme süresi (p < 0.05), hipovolemik şok (p < 0.001) ve cerrahi yöntem (p < 0.001) olduğu saptanmıştır. Primer tamir yönteminin mortalitesi kolostomiye oranla daha düşük olarak bulunmuştur.

-25- SUMMARY: One hundred ninety one patients treated for colon injuries betwen years 1980-1989 were reviewed retrospecti vely and results of surgical treatment were evaluated. Ni nety four percent of our patients were male and the pati ent average age was 28.5 with most of the injuriesC 94%) caused by penetrating abdominal trauma. The time from injury to hospitalization was greater than 6 hours in 33% and shock was present in 25%of the ca ses. One hundred forty six patients had a total of 296 associated injuries and only 45 patients (23.56%) had isola ted colon injuries. Primary repair was employed in 68. 5% and colostomy in 31.5% of the cases. While the rate of primary repair was 95.6% in injuries of the right colon this rate was 72.3% in transvers colon injuries, 42.39% right colon injuries. The mortality rate was 15.7% and the factors significatly asso ciated with mortality were the number of associated injuri es (p<0.05), delay time (p^.0.05), hypovolemic shock (p^p.001), and surjical treatment method (p^.0.001). The mortality rate for primary repair was found to be lower than the rate for colostomy., Primary repair can be employed in patients admitted before 6 hours and without multiple associated injuries.