Cullinane DC, et al. - In order to develop a practice management guideline for surgeons, this meta-analysis was performed assessing the current treatment regimens available for penetrating colon injuries and evaluating the role of anastomosis in damage control surgery. A subcommittee of the Practice Management Guidelines section of EAST used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to conduct a systematic review using MEDLINE and EMBASE articles from 1980 through 2017. Sixteen of 37 identified studies met criteria for quantitative meta-analysis and included 705 patients considered low-risk in six prospective randomized studies. As per findings, researchers recommend performing colon repair or resection and anastomosis (R&A) rather than routine colostomy in adult civilian patients sustaining penetrating colon injury without signs of shock, significant hemorrhage, severe contamination, or delay to surgical intervention. They conditionally recommend performing colon repair or R&A rather than routine colostomy in adult high-risk civilian trauma patients sustaining penetrating colon injury. In adult civilian trauma patients sustaining penetrating colon injury who had damage control laparotomy, they conditionally recommend not performing routine colostomy; instead, they recommend performing definitive repair or delayed R&A or anastomosis at initial operation rather than a routine colostomy.