ArticleCureus2025
Indications and Outcomes of Colon Resection in a Conflict Zone: A Single-Center Experience From a Military Hospital in Yemen.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough colon resection is a common procedure, data on its indications and outcomes in conflict-affected regions are limited. These environments present unique surgical challenges, driven by the dual burden of acute trauma and advanced-stage chronic diseases. This study aimed to analyze the experience of colon resection to identify key risk factors and inform surgical practices in austere settings.
methodsA single-center prospective observational study was conducted on 89 patients who underwent colon resection at a military hospital in Sana'a, Yemen, between September 2022 and April 2024. Data on patient demographics, indications, surgical procedures, and postoperative outcomes were collected and analyzed. The primary endpoint was the incidence of adverse outcomes, defined as a composite of significant morbidity and in-hospital mortality.
resultsA total of 89 patients were included (mean age 36.9 years; n=81, 91.0% male). The predominant indication was penetrating trauma (n=70, 78.7%). The overall adverse outcome rate was 19.1% (n=17), comprising a significant morbidity rate of 7.9% (n=7) and an in-hospital mortality rate of 11.2% (n=10). Significant morbidity included events such as anastomotic leak requiring re-operation. Patients presenting with shock on admission had a higher adverse outcome rate than stable patients (34.6% vs. 12.7%); this represented a strong clinical trend that approached statistical significance (OR 3.47, 95%CI 0.95-12.69; P=0.066).
conclusionIn this conflict-zone hospital, the patient's initial physiological state, particularly the presence of shock, was the most critical determinant of the postoperative outcomes. Despite the austere conditions, the observed anastomotic leak rate suggests that primary anastomosis is a viable option for carefully selected, hemodynamically stable patients. These findings underscore the need for context-specific guidelines that prioritize physiological risk stratification to guide surgical decision-making.
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