Morbidity of ileostomy and colostomy closure: impact of surgical technique and perioperative treatment.
The operative results and complications after stoma closure in 548 patients operated on between 1972 and 1993 are described in this retrospective study. The patients were divided into three groups (group I,n = 74, 1972-1976; group II,n = 256, 1977-1985; group III,n = 218, 1986-1993) according to the year of operation and changing concepts in colorectal surgery. The overall mortality rate was 2.0%. The morbidity rate including minor complications was significantly reduced from 70.3% in group I to 27.1% in group III. Postoperative wound infections and fever were the most common complications. The location of the stoma and the operative technique did not markedly influence the morbidity rate. The most striking decrease in complications was achieved by the combined usage of orthograde lavage and perioperative antibiotic treatment (14.6% wound infections, 6.9% postoperative fever). In conclusion, a standardized perioperative treatment protocol including orthograde lavage and antibiotics is recommended.
Riesener
K P
KP
Department of Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52057 Aachen, Germany.
Lehnen
W
W
Höfer
M
M
Kasperk
R
R
Braun
J C
JC
Schumpelick
V
V
D019072:Antibiotic Prophylaxis; D003125:Colostomy / Q000379:methods / Q000401:mortality; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007081:Ileostomy / Q000379:methods / Q000401:mortality; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000453:epidemiology