Outcomes of Primary Repair and Anastomosis for Traumatic Colonic Injuries in a Tertiary Trauma Center

Background: Surgical management for traumatic colonic injuries has undergone major changes in the past decades. Despite the increasing confidence in primary repair for both penetrating colonic injury (PCI) and blunt colonic injury (BCI), there are authors still advocating for a colostomy particularly for BCI. This study aims to describe the surgical management of colonic injuries in a level 1 metropolitan trauma center and compare patient outcomes between PCI and BCI. Methods: Twenty-one patients who underwent trauma laparotomy for traumatic colonic injuries between January 2011 and December 2018 were retrospectively reviewed. Results: BCI accounted for 67% and PCI for 33% of traumatic colonic injuries. The transverse colon was the most commonly injured part of the colon (43%), followed by the sigmoid colon (33%). Primary repair (52%) followed by resection-anastomosis (38%) remain the most common procedures performed regardless of the injury mechanism. Only two (10%) patients required a colostomy. There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates (55% vs. 50% vs. 50%, p = 0.979) and length of hospital stay (21 vs. 21 vs. 19 days, p = 0.991). Conclusions: Regardless of the injury mechanism, either primary repair or resection and anastomosis is a safe method in the management of the majority of traumatic colonic injuries.