Review of colostomy in a community hospital

This review of 193 colostomies was carried out to assess the procedure in our institution from standpoints of indications, technique, complications, and results. The study revealed colostomy was most commonly performed for obstruction, abdominoperineal resection, and infection or fistula associated with carcinoma, diverticulitis, and trauma in that order of frequency. The mortality rate was 2.6 per cent. Complications were observed in 22 per cent with 11 per cent being directly related to the colostomies themselves. Colostomy closure was accompanied by a 17 per cent complication rate and 1.5 per cent mortality. These overall results compare well with those of other investigators. Higher complication rates were found for colostomy for diverticulitis vs carcinoma; abscess or fistula vs obstruction or abdominoperineal resection; and for colostomy in the operative incision vs separate incision. The lowest rate was for colostomy for trauma. No significant difference in complication rate between transverse and sigmoid colostomies and colostomy closure by resection and anastomosis vs simple closure were noted.