[Protective colostomy or ileostomy?] ]

A group of patients is presented, where colorectal or coloanal anastomosis after resection was performed together with concomitant covering colostomy (102) or ileostomy (25), during the period 1985-2000. Covering colostomy was most often performed upon hepatic flexure (82.1%) and upon sigmoid colon (8.9%). The incidence of complications during performing or closure of colostomy was 6.8% with one case (0.8%) of death due to unsuccessful protection of primary anastomosis. The incidence of complications in covering ileostomy was 16%, with 3 (12%) deaths. Authors are analysing the data from literature about indications and technique of covering enterostomies, comparing them with their experience and concerning the choice of appropriate protective procedure. They came to conclusion that the reason for covering procedure has been in many instances reasonable, and that in the question of protection both methods are comparable, but covering ileostomy has potentially more dangerous complications. Therefore as a method of anastomotic protection authors are generally recommending covering colostomy except in technically specific cases.