The liberal use of the colostomy was the greatest single factor in reducing the mortality of colon and rectal injuries. Thus, colostomy closure as well as colostomy is now a common, elective operation that carries the risk of significant
morbidity
morbidity and even an occasional death.
We have reviewed and analyzed the results of 38 patients with colostomy closure at the Fatima Hospital, Taegu, Korea from January 1987 to december 1992.
@ES The results were as follows:
@EN 1) The underlying disease of colostomy closure was trauma in 14 cases(36.8%), cancer in 8 cases(21.1%), rectovaginal fistula in 7 cases(18.4%) and miscellaneous in 9 cases(23.7%).
2) The postoperative complication occured in 12 cases(31.6%) and appeared to be more common in the trauma group(35.7%) than in the other group(29.25).
3) There was no significant difference between the transverse colostomy and the sigmoid colostomy. Anastomotic stenosis appeared to be more common in the transverse colostomy, but wound infection in the sigmoid colostomy.
4) In the time interval within 3 months between defintive surgery and colostomy closure the complication occured in 8 cases(34.8%) but after 3 months in 4 cases(26.7%).
5) In management factors affecting the complications, the complication rate of patient with or without antibiotics bowel preparation was 27.3% or 33..3%. And the complication rate of colonic resection with end to end anastomosis was 33.3%(12
cases) and
of and of skin closure was 31.6% (12 cases).
The authors conclude that the location and type of colostomy, timing, method of colostomy, timing, method of closure and patients population seem to less important factor. The most important factor is meticulous surgical technic.
|