Complications following colostomy closure.

概要

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The results of colostomy closure in 33 patients were analyzed for contributing factors of postoperative complications. Stoma constructions were indicated for 14 colorectal carcinomas (42.4%), 5 diverticular diseases (15.2%), 3 Hirschsprung's diseases (9.1%), etc. Twenty-four stomas were loop colostomies (72.7%). Prior to laparotomy, the stoma was inverted and closed with tight interrupted sutures. Then the stoma resections and intraperitoneal bowel anastomosis for gastrointestinal continuity were performed.<BR>There was no operative motality. The overall complication rate was 42.4% (14 complications on 14 cases), including 7 wound infections (21.2%), 4 anastomotic leaks or fecal fistuli (12.1%), 2 stenoses (6.1%) and one small bowel obstruction (3.0%). The complications were analyzed statistically to assess the correlation with age, underlying diseases, type of colostomy, time interval between construction and closure, antibiotic preparation, type of laparotomy, presence or absence of drains, duration of operation and blood loss volume. No significant relationship was found statistically between these factors.<BR>Complication rate was high after closure of colostomy. It is concluded that careful surgical technique as well as adequate preparation are needed to reduce complications.
日本大腸肛門病学会の論文