Factors that Influenced Selection of Operations in Colon Injury-ปัจจัยที่มีผลต่อการเลือกวิธีผ่าตัดผู้ป่วยที่มี การบาดเจ็บบริเวณลำไส้ใหญ่

Abstract

          The purpose of this retrospective analytical study was to compare factors that influenced selection of operations in colon injury and results between patients receiving primary repair (PR) or colon resection with anastomosis (RA) and receiving diverting colostomy (DC) for 48 patients at Paholpolpayuhasena hospital, Kanchanaburi during 2003 - 2007. All patients included were those who had colon injury score in grade 2-5, received prophylaxis antibiotic before operation and were not dead within 48 hours after operation.  There were 64.58 percent of patients receiving PR or RA and the others receiving DC.  After statistical testing by chi-square and Fisherีs exact test, it was found that the mortality rate after DC (11.76%) was significantly higher than those of PR or RA. No fatalities among patients undergoing PR or RA were reported. Factors that surgeons preferred to select DC in patients were shock in emergency room, large amount of blood loss (> 2,000 milliliter) and blood transfusion (>3 units) in operating room, and severe colon injury (grade 4-5) (p - value < 0.05).

Key words:  colon injury, colostomy