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J R Soc Med. 1994 May; 87(5): 265–267.
PMCID: PMC1294517

Wartime colon injuries: primary repair or colostomy?


A retrospective non-randomized study, comparing primary repair with colostomy, was made on a series of 102 patients with penetrating intraperitoneal colon injuries, in a war surgery programme in Cambodia. The overall case fatality rate (CFR) was 25.5%, whereas in the primary repair group CFR was 20%, compared to 30.8% in the colostomy group. The difference was not statistically significant (P = 0.30). Adjustment for possible confounding factors in the two groups did not alter the results. Considering the numerous advantages to the patient of a primary closure in the precarious situations where war surgery is often performed, this technique merits consideration.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Garfinkle SE, Cohen SE, Matolo NM, Getzen LC, Wolfman EF., Jr Civilian colonic injuries. Changing concepts of management. Arch Surg. 1974 Sep;109(3):402–404. [PubMed]
  • Stone HH, Fabian TC. Management of perforating colon trauma: randomization between primary closure and exteriorization. Ann Surg. 1979 Oct;190(4):430–436. [PubMed]
  • Shannon FL, Moore EE. Primary repair of the colon: when is it a safe alternative? Surgery. 1985 Oct;98(4):851–860. [PubMed]

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