Colostomy closure. Ochsner Clinic experience.
OBJECTIVE
We retrospectively reviewed the records from our past five years of experience with colostomy closure at a large multispecialty hospital to determine postoperative morbidity.


RESULTS
From March 1988 to April 1993, 46 patients underwent colostomy closure. Patients ranged in age from 24 to 87 (mean, 41.8) years, and 25 (54 percent) were women. Stomas had been created during emergency operations in 40 patients (87 percent); most operations (54 percent) were for complications of acute diverticulitis. Of the 46 procedures, 40 (87 percent) were end colostomies, and 6 were loop colostomies. Stomas were closed at a range of 11 to 1,357 days after creation (mean, 207 days; median, 116 days). Twenty-six patients (57 percent) underwent colostomy closure alone, and the remainder underwent additional procedures ranging from appendectomy to hepatic lobectomy. Duration of operations ranged from 1 to 9.5 (mean, 4.2) hours, and estimated blood loss averaged 400 ml. Overall hospital stay for closure was 6 to 62 (mean, 11.5) days. Inpatient complications occurred in 15 percent of patients, including congestive heart failure (2 percent), cerebrovascular accident (4 percent), pneumonia (2 percent), enterocutaneous fistula (2 percent), and pulmonary embolus with death (2 percent). The most common long-term complication was midline wound hernia, which occurred in 10 percent of surviving patients. Overall, complications occurred in 24 percent.


CONCLUSIONS
Colostomy closure is a major operation; however, with good surgical judgement and technique, associated morbidity and mortality can be minimized.
Khoury
D A
DA
Department of Colon and Rectal Surgery, Ocbsner Clinic, New Orleans, Louisiana 70121, USA.
Beck
D E
DE
Opelka
F G
FG
Hicks
T C
TC
Timmcke
A E
AE
Gathright
J B
JB
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003125:Colostomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D004238:Diverticulitis / Q000150:complications; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors