TALEI A, GHOREISHI S. A COMPARATIVE ST UDY OF THERAPEUTIC RESULTS OF RIGH T AND LEFT COLONIC INJURIES SUSTAINED BY IRANIAN SOLDIERS IN THE IRAN-IRAQ WAR. Med J Islam Repub Iran 2000; 13 (4) :241-246
URL:
http://mjiri.iums.ac.ir/article-1-912-en.html
From the Dept. of Surgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, I R. Iran.
Abstract: (4311 Views)
The treatment strategy of colonic injuries is a debatable and highly controversial
subject worldwide in various medical centers. The method of treatment of left and
.. right colonic injuries, diversity or similarity in their management and particularly
differences between the treatment of war-associated injury from other types of
colonic damage are among the unsettled issues.
The present study involves a review of 226 medical records belonging to male
Iranian soldiers 15-54 years of age admitted to 3 hospitals affiliated to Shiraz
University of Medical Sciences for injuries sustained during eight years of the
Iran-Iraq war. Differences with respect to therapeutic results, symptoms and
mortality rates were studied between the two groups of patients with left and right
colonic injury with reference to the various surgical treatments employed. Ninety two
(40.7%) and 134 (59.3%) cases suffered from injuries of the right and left
colon, respectively. The majority (91.6%) had undergone primary surgical
treatment in field hospitals before being dispatched to our hospital for convalescence
and continuation of therapy.
Our study indicates that in the presence of identical side-conditions and
regardless of anatomical sites, both right and left colon injury can be treated
similarly with no significant differences between the two groups (p=0.804). The
peculiarities relating to each case demanded a particular surgical therapy. As
compared with the results obtained from other surgical therapies the best surgical
management of war-associated colonic injuries with the least sequelae is
exteriorization (p=0.0000002) which is of first priority, whereas resection of the
damaged segment accompanied by colostomy or ileostomy is of second preference.
The use of antibiotics in the early phases of colonic injury is mandatory and a rapid
diagnosis followed by expedient surgical therapy is of fundamental importance.
Therefore, the most effective and convenient process for immediate treatment of
wartime injuries is the establishment of reliable and equipped centers in the
vicinity of battle zones.
Type of Study:
Original Research |
Subject:
Surgery