[Complications of colostomies and colostomy closure]

Three hundred and sixty patients underwent 369 colostomies over 7 years, 66 for benign and 303 for malignant disease, and were followed up for an average of 20 months. Stomas were made electively in 246 cases and urgently in 123. Thirty-seven stomas were brought out through incision and 332 from separate sites. End colostomy was made in 179 cases, loop colostomy in 136 and double barrel colostomy in 54. There were 102 complications in 85 patients (27.6%). The most common complication was wound infection (10.8%). The total number of complications was not related to the urgency of the procedure, the disease process, or the stoma site. Wound infection, however, increased in incisional stomas. Extraperitoneal tunneling of end colostomy did not decrease the complication rate of parastomal hernia or intestinal obstruction. Sixteen cases (4.3%) received another operation for complications. Eighty-five patients the colostomy closed on an average of 3.4 months after its creation. Four patients had 5 complications (5.9%). Two patients required another operation. Complications increased with Hartmann closures and may be related to the timing of the colostomy closure.