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Rectal perforations. Personal experience and literature review
B Di Venere1, M Testini, S Miniello
1Section of General Surgery, Vascular Surgery and Clinical Oncology, Department of Applications in Surgery of Innovative Technologies, University of the Study, Bari, Italy.
Minerva Chirurgica
|May 25, 2002
Summary
Rectal perforation treatment lacks standardization, leading to high risks. A standardized protocol based on injury severity can reduce morbidity and mortality from rectal perforation.
Area of Science:
- Colorectal Surgery
- Surgical Gastroenterology
- Trauma Surgery
Background:
- Rectal perforation is associated with significant morbidity and mortality.
- Current treatment strategies for rectal perforation are not standardized and often rely on surgeon experience.
- This study reviews diagnostic and therapeutic options to mitigate risks.
Purpose of the Study:
- To define rectal perforation lesions.
- To identify diagnostic and therapeutic strategies for reducing rectal perforation-related morbidity and mortality.
- To propose a standardized protocol for managing rectal perforations.
Main Methods:
- Retrospective analysis of 1175 colorectal emergency operations over ten years.
- Inclusion of fourteen consecutive patients treated for rectal perforation.
- Surgical treatments included Hartmann's procedure, rectal wound repair with diverting colostomy, and diverting colostomy alone.
Main Results:
- No postoperative complications were observed in 86% of patients.
- No deaths attributed to sepsis occurred.
- Bowel continuity was restored in 28.5% of cases.
Conclusions:
- A standardized protocol is crucial for managing rectal perforations.
- Treatment decisions should be guided by patient condition, injury type/degree, and peritonitis severity.
- Implementing a standardized protocol can effectively reduce morbidity and mortality associated with rectal perforation.