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Same admission colostomy closure: a prospective, randomised study in selected patient groups
M S Khalid1, S Moeen, A W Khan
1Department of Surgery, Lahore General Hospital, Lahore, Pakistan. sufian999@hotmail.com
Summary
Same admission colostomy closure (SACC) is as safe as conventional delayed colostomy closure (CDCC) but significantly reduces hospital stay and costs for patients with colorectal injuries.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Trauma Management
Background:
- Colostomy remains crucial for colorectal pathologies despite primary repair trends.
- Optimal timing for colostomy closure is debated among surgeons.
- This study focuses on traumatic large bowel injuries.
Purpose of the Study:
- To compare outcomes of same admission colostomy closure (SACC) versus conventional delayed colostomy closure (CDCC).
- To evaluate safety, hospital stay, and cost-effectiveness of SACC.
Main Methods:
- Prospective, randomized study of 60 patients with colorectal pathologies.
- Patients were randomized to SACC (30) or CDCC (30) groups.
- Intraperitoneal closure technique used for all colostomies.
Main Results:
- Complication rates were similar: 23.3% for SACC vs. 26.6% for CDCC (p = 0.83).
- SACC significantly reduced mean hospital stay (p < 0.01).
- SACC significantly decreased overall costs (p < 0.001).
Conclusions:
- Same admission colostomy closure is a safe option for selected patients.
- SACC offers significant benefits in reduced hospital stay and cost-effectiveness.
- This approach is valuable in managing traumatic colorectal injuries.