Criteria for Primary or Two-Stage Diversion Procedures in Colon Injuries: Experience from a Tertiary Care Center in Montenegro

Modern literature supports primary repair in a wide array of colon injury presentations. The aim of the study was to evaluate the validity of criteria for primary repair of colon injuries. The analysis involved 96 patients with colon injuries. Group 1 (62 patients) underwent the Stone and Fabian (S/F) criteria for primary repair, whereas group 2 (34 patients) underwent the following exclusion criteria for primary repair: significant peritonitis, edema/ischemia of a large area/multiple colonic segments, latent period >8 h, and intraoperative cardiorespiratory instability. The following variables were analyzed: demographic data, mechanism of injury, latent period, distribution of injuries, macroscopic intraoperative finding, and several trauma indices. The mean latent period was shorter in group 2 (1.3±1.1 h) versus group 1 (4.9±3.7 h). Primary repair was more frequent in group 2. There was no difference in the success rate of the primary procedures between the two groups according to Flint grade or S/F criteria. Primary repair is safe and recommended in the first 8 h after injury in hemodynamically and respiratory stable patients without intra-abdominal sepsis.