Closure of colostomy

Abstract

In this review of 179 patients in whom colostomy closure was performed the mortality from the operation was 2·2 per cent and the morbidity from faecal fistula was 23 per cent. This operation, there fore, should not be regarded as a minor procedure. Complications in patients with diverticular disease following colostomy closure are lowest when the operation is carried out 3 months or more after resection. After resection of a carcinoma, complications are lowest if the colostomy closure is carried out after 2 months.

The results of colostomy closure

“…However, the present results suggest that the safest time to close a colostomy is 3 months after definitive surgery, the major complication rate being lowest at this time (3.1 per cent). A similar conclusion was reached by Knox et al (1971), but they recommended that a delay of 2 months was sufficient in cases of carcinoma. No such relationship between disease process and safe time interval could, however, be demonstrated in the present series.…”

Morbimortalidade da reconstrução de transito intestinal colônica em hospital universitário: análise de 42 casos

“…Vários fatores de risco tem sido implicados na literatura no desenvolvimento de complicações após o fechamento de colostomia, por exemplo, experiência do cirurgião (5,11) , doença primária (2) , localização do estoma (12) , técnica operatória (13) e o tempo de intervalo entre a primeira operação e o seu fechamento (3,11,(14)(15)(16) . Infelizmente os resultados são conflitantes entre as séries relatadas.…”

“…O período médio de fechamento de uma colostomia aceito pela comunidade médica varia de 12 a 16 semanas, pelo fato que ocorreriam maiores índices de complicações se o fechamento ocorresse em um período inferior a 3 meses (3,23) . Esses dados são questionados por alguns centros, que preconizam uma reconstrução mais precoce sem um aumento significativo nas taxas de complicações (10,11,22,25) .…”

Die Morbidit�t und Letalit�t des intraperitonealen Verschlusses der doppell�ufigen Transversumfistel

“…Was den Zeitpunkt des Colostomieverschlusses anbelangt, so besteht bei der fiberwiegenden Mehrzahl der Autoren ebenfalls kein Zweifel mehr daran, dab jeder Verschlug innerhalb der ersten 6 Wochen nach Anlage der Colostomie mit einer unvergleichlich h6heren Morbidit/it einhergeht als ein Verschlug zu einem sp~iteren Zeitpunkt [6,12,13,15,18,20,23]. Dies zeigt sich in unserem Krankengut erschreckend deutlich an einer Morbidit/it von 100 ~o.…”

“…Kontrovers ist derzeit auch die Frage, ob das zugrunde liegende Krankheitsbild, Sigmadiverticulitis oder Carcinomleiden von unterschiedlichem Einflug auf die Morbiditfit des Colostomieverschlusses ist [11,12,15,19,23,24]. In unserem Krankengut konnten wit keine derartige Abh~ingigkeit feststellen, wohingegen von anderen Autoren fiber eine um 50 ~o h6here Komplikationsrate bei der Diverticulitis berichtet wird [15].…”