Colon injuries in the presence of complete spinal cord injury: Primary repair or colostomy?

BACKGROUND

Complete spinal cord injury (SCI) is associated with severe colon dysmotility and therefore may be associated with higher risk of leak following primary repair or anastomosis for concomitant colon injury.

METHODS

TQIP database study, patients with complete SCI and associated colon injuries who underwent primary repair (PR) or resection with primary anastomosis (RPA) were compared to those who underwent ostomy alone using propensity score matching.

RESULTS

Ninety-nine patients treated with a colostomy were matched with 215 treated with PR or RPA. Patients treated with colostomy were more likely to develop severe sepsis post-operatively (13.1 ​% vs 4.2 ​%, p ​= ​0.004). Subgroup analysis, comparing colostomy versus PR or colostomy versus RPA, showed again a higher incidence of postoperative severe sepsis in the colostomy group.

CONCLUSIONS

Primary repair and/or RPA are associated with a lower incidence of postoperative severe sepsis than colostomy and should be considered in patients with combined SCI and colon injury.