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Colostomy closure on a gynecologic oncology service
M S Hoffman1, N Gleeson, D Diebel
1Department of Obstetrics and Gynecology, Tampa General Hospital, Florida.
Gynecologic Oncology
|June 1, 1993
Summary
Colostomy closure is a viable procedure for select gynecologic cancer patients. This study found a 16% complication rate, including one mortality, but concluded closure is reasonable.
Area of Science:
- Surgical Oncology
- Gastroenterology
Background:
- Colostomies are frequently performed in gynecologic cancer patients.
- Closure of colostomies can be complex, with potential complications.
- Data on colostomy closure outcomes in gynecologic cancer patients is limited.
Purpose of the Study:
- To evaluate the safety and efficacy of colostomy closure in patients with gynecologic cancer.
- To determine the complication rate associated with colostomy closure in this population.
Main Methods:
- Retrospective review of 25 colostomy closures performed between July 1985 and June 1992.
- Analysis of patient demographics, indications for colostomy, closure technique, and postoperative outcomes.
- Categorization of complications, including intraoperative and postoperative events.
Main Results:
- Twenty-one colostomies were related to gynecologic cancer; 4 were for benign pelvic disease.
- Nineteen patients had simple loop colostomy closure; 6 had closure during laparotomy.
- Overall complication rate was 16% (3 patients), including wound dehiscence, infection, and anastomotic stricture. One postoperative mortality occurred due to adult respiratory distress syndrome.
- One patient required a second colostomy due to recurrent ovarian cancer obstruction.
Conclusions:
- Colostomy closure appears to be a reasonable surgical undertaking in carefully selected gynecologic cancer patients.
- While complications can occur, the benefits of closure may outweigh the risks in appropriate candidates.
- Further research with larger cohorts is warranted to confirm these findings.