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[Colostomy closure: is it an intervention without risk?]
J P Paredes1, M Caínzos, J García
1Servicio de Cirugía General, Hospital General de Galicia, Universidad de Santiago de Compostela.
Objective:
To examine whether colostomy closure is an operation with a high risk of complications.
Design:
Retrospective study of colostomy closures in a 14-year period.
Participants:
60 patients, averaging 54 years, males in 63%. The main indication for colostomy was colorectal neoplasm (47%), followed by trauma (23%).
Results:
There were 15 Hartman's procedure reconstructions, 4 reconstructions of colostomy and mucous fistula, and 41 "simple" colostomy closures. The closure was extraperitoneal in 40%, suturing only the anterior colonic wall in 42%. We had 27 postoperative complications in 33% of the patients, without mortality. The average hospital stay was 8 days longer in the group with complications. The complication rate was 29% in the "simple" closure versus 42% in the reconstruction group (this difference was not statistically significant). The statistic analysis (chi-square and Mann-Whitney tests) showed no influence on morbidity of factors such as age, sex, previous disease, age of colostomy, and type and closure technique of colostomy.
Conclusions:
Colostomy closure has a high rate of postoperative complications (33%). These are minor in almost all cases, without mortality.