A study comparing split with loop transverse colostomies for defunctioning the left colon

Loop transverse colostomy (LTC) is an established method for defunctioning the distal colon. We recently described an alternative method called split transverse colostomy (STC).

In this study we retrospectively compared the outcomes of LTC and STC in 49 patients with colorectal malignancy, pelvic tumours and diverticular disease.

Patients were assigned without randomisation to undergo LTC (n=25) or STC (n=24). The two groups were similar in terms of age, gender and diagnosis. Postoperative complications were observed in 52.0% of patients in LTC group and in 16.7% of patients in STC group (p<0.05). The most common complication in both groups was stomal prolapse (n=2 and n=10, respectively). There were no intra-operative deaths.

STC is safe, effective and associated with a lower incidence of stomal complications compared with the established procedure for defunctioning the distal colon. We propose that STC should be used to defunction the left colon in locally advanced disease (whether benign or malignant) where closure of the stoma is not envisaged.