Ileocecectomy as an Acceptable Alternative to Right Hemicolectomy in Trauma: A Propensity Score Matched TQIP Analysis

BackgroundIleocecectomy (IC) as an alternative to right hemicolectomy (RH) for traumatic indication is controversial with limited comparison data. We sought to compare IC vs RH for traumatic injury and hypothesized there was no difference in outcomes.MethodsThe Trauma Quality Improvement Program database was queried from 2017 to 2022 with IC and RH patients evaluated using propensity score matching (PSM) in a 1:3 ratio. Presenting factors and outcomes were analyzed.ResultsAfter PSM, 558 RH and 186 IC patients had no difference in age, penetrating mechanism, time to OR and injury severity score. RH patients were more likely to have unplanned ICU admission (8.6% vs 3.8%, P = 0.03) and organ space infection (7.5% vs 3.2%, P = 0.04) but similar rates of acute kidney injury (P = 0.5), unplanned OR (P > 0.9) and mortality (P = 0.08) compared to IC patients.ConclusionsTraumatic colon injury managed by ileocecectomy had similar outcomes compared to right hemicolectomy and should be considered an acceptable alternative when anatomically feasible.