[Perineo-ano-rectal injuries: clinical experience]

Area of Science:

• Colo-proctology
• Trauma Surgery
• Surgical Repair

Background:

• Traumatic injuries to the anus, perineum, and rectum are rare but challenging to manage.
• Effective treatment requires expertise in both trauma and colo-proctological surgery.
• Early complications significantly impact treatment failure and long-term disability.

Purpose of the Study:

• To analyze clinical experience with complex traumatic lesions of the perineum, anus, and rectum.
• To evaluate treatment strategies, complications, and outcomes in these injuries.
• To determine the optimal timing and approach for surgical repair.

Main Methods:

• Retrospective analysis of 7 patients with complex traumatic perineo-ano-rectal lesions.
• Evaluation of injury causes, types, surgical treatment (primary vs. secondary repair), and complications.
• Exclusion of gynecological/obstetric and non-sphincter-involving injuries.

Main Results:

• Five impalement injuries, one explosion, and one motorboat propeller injury were reported.
• Six patients (85.7%) underwent direct primary repair; one (14.3%) had secondary repair post-colostomy.
• All patients achieved complete lesion recovery with low rates of early complications (28.6%) and minimal persistent sphincter dysfunction (14.3%).

Conclusions:

• Early surgical intervention is often curative for complex perineo-ano-rectal trauma.
• Colostomy should be reserved for specific, complex cases.
• Successful outcomes depend on trauma experience, surgical timing, and knowledge of diverse surgical options.