Same admission colostomy closure: a prospective, randomised study in selected patient groups.
BACKGROUND
Despite a recent trend towards primary repair, colostomy still has an important place in the management of different colorectal pathologies. Timing of colostomy closure is a debatable issue among general surgeons. We carried out a prospective, randomised study to compare the outcome after same admission colostomy closure (SACC) and conventional delayed colostomy closure (CDCC) in patients with predominantly traumatic injury of the large bowel.


METHODS
Sixty patients, the majority with traumatic colorectal pathologies, were prospectively randomised to SACC [30 patients, 23 men, mean age 27.9 +/- 9.7 (range, 18-65) years] or (CDCC) [30 patients, 24 men, mean age 28.6 +/- 10.6 (range, 18-63) years]. All colostomies were closed using an intraperitoneal closure technique. Pre-operative data and post-operative outcomes were collected and analysed.


RESULTS
A total of seven patients (23.3%) with SACC developed complications compared with eight patients (26.6%) having CDCC (p = 0.83). The mean hospital stay (p < 0.01), as well as the overall cost (p < 0.001), were significantly less in the SACC group.


CONCLUSIONS
Same admission colostomy closure is a safe and cost-effective technique for colostomy closure in selected groups of patients.
Khalid
M S
MS
Department of Surgery, Lahore General Hospital, Lahore, Pakistan. sufian999@hotmail.com
Moeen
S
S
Khan
A W
AW
Arshad
R
R
Khan
A F A
AF
D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D003125:Colostomy; D003362:Cost-Benefit Analysis; D013505:Digestive System Surgical Procedures / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007420:Intestine, Large / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome