The utility of presacral drainage in penetrating rectal injuries in adult and pediatric patients

Savoie, Kate B.; Beazley, Thomas M. M.; Cleveland, Brent; Khaneki, Sina; Markel, Troy A.; Hammer, Peter M.; Savage, Stephanie A.; Williams, Regan F.

doi:10.1016/j.jss.2017.05.056

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…Penetrating rectal/perineal injuries occurred in children with ages ranging between 5-13 years (mean nine years), with slight male predominance 17 . All of the cases treated with repair with either diverting colostomy (83%) or not (17%); this selection governs by assessment after anesthesia and proctoscopy; this is generally matching the general practice in several studies 18,19 . Although Ameh EA, from Nigeria, proposed a successful standard treatment with diversion for all cases 20 .…”

Section: Resultsmentioning

confidence: 99%

Acquired Ano Rectal Conditions (AARC) in Children Seen at Gezira National Center for Pediatric Surgery (GNCPS-Sudan), Epidemiology, Management, and Outcome

2021

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The study's main objective is to determine the epidemiology, treatment, and outcome of the acquired anorectal conditions seen at the GNCPS. This study was a retrospective and prospective descriptive hospital-based study involving (131) child with Acquired anorectal conditions (AARC) who presented to GNCPS during the two-year study period. Data regarding the presentation, management, and post-operative course to look after complications and outcomes were collected. Data were collected using a formulated questionnaire and analyzed using (SPSS 17). Data considered statistically significant when P-value is less than 0.05. The study involved a total number of 131 children with AACS. The mean age of presentation is (5.78 years) with an overall 1.4:1 male to female ratio. Most of the study subjects are from rural areas, 66.4 percent. Most of them treated surgically, 83.2 percent, and 16.8 percent medically, with an overall complication rate of 24.4 percent. Conclusion Acquired Ano Rectal Conditions commonly seen at the preschooler age, mean (5.78 years). Rectal polyps and rectal prolapse were among the most frequently seen acquired anorectal conditions in children. Most of the cases treated surgically with an overall complication rate of 24.4 percent.

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Section: Resultsmentioning

confidence: 99%

Acquired Ano Rectal Conditions (AARC) in Children Seen at Gezira National Center for Pediatric Surgery (GNCPS-Sudan), Epidemiology, Management, and Outcome

2021

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“…Distal rectal wash and presacral drainage are now obsolete being of no definite advantage. 22,23 Likewise, bladder sphincter or urethral injury requires urinary diversion in the form of suprapubic cystostomy. Some, as in our present study, later needed percutaneous nephrostomy due to a high output vesico-cutaneous and vesico-rectal fistula respectively.…”

Section: Discussionmentioning

confidence: 99%

Magnitude and outcomes of complex perineal injury – A retrospective analysis of five years’ data from a Level 1 trauma centre

et al. 2021

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Complex perineal injuries pose a major diagnostic and therapeutic challenge to trauma surgeons. A retrospective review of the hospital records of 29 patients with complex perineal injury following blunt trauma was done. Demographic profile, management and outcomes were collected. Quality of life analysis was conducted for patients with complex perineal injuries who were discharged. The most predominant mode of injury was a road crash: being a pedestrian run over by a heavy motor vehicle. Pelvic fracture was seen in 20, anorectal involvement in 22 and urogenital injuries in 14. Urgent surgical debridement was done in all patients, faecal diversion in 27 and urinary diversion in 14. There were nine deaths, three from haemorrhage, and the remainder from sepsis and multi-organ dysfunction. Complex perineal injury remains a major cause of morbidity and mortality in trauma patients. There is a need to ensure adequate rehabilitation services for such patients.

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“…In particular, the utility of distal rectal washout appeared minimal or nonexistent, 8,37,38 and it gradually fell out of favor. Contemporary studies began to question the utility of presacral drainage and failed to demonstrate a clear benefit from the intervention 39–41 . An RCT of 48 patients with penetrating extraperitoneal rectal injuries published in 1998 showed no impact on infectious complications from presacral drainage and recommended the technique be abandoned 42 .…”

Section: Other Areas Of Controversymentioning

confidence: 99%

“…Contemporary studies began to question the utility of presacral drainage and failed to demonstrate a clear benefit from the intervention. [39][40][41] An RCTof 48 patients with penetrating extraperitoneal rectal injuries published in 1998 showed no impact on infectious complications from presacral drainage and recommended the technique be abandoned. 42 An Eastern Association for the Surgery of Trauma practice management guideline on nondestructive penetrating extraperitoneal injuries recommended against the routine use of distal rectal washout or presacral drainage.…”

Section: Presacral Drainage and Distal Rectal Washoutmentioning

confidence: 99%

Diagnosis and management of traumatic rectal injury: A Western Trauma Association critical decisions algorithm

Schellenberg

Koller

Moya

et al. 2023

J Trauma Acute Care Surg

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The utility of presacral drainage in penetrating rectal injuries in adult and pediatric patients

Cited by 8 publications

References 25 publications

Acquired Ano Rectal Conditions (AARC) in Children Seen at Gezira National Center for Pediatric Surgery (GNCPS-Sudan), Epidemiology, Management, and Outcome

Acquired Ano Rectal Conditions (AARC) in Children Seen at Gezira National Center for Pediatric Surgery (GNCPS-Sudan), Epidemiology, Management, and Outcome

Magnitude and outcomes of complex perineal injury – A retrospective analysis of five years’ data from a Level 1 trauma centre

Diagnosis and management of traumatic rectal injury: A Western Trauma Association critical decisions algorithm

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