1 Jul 2019Article
Evaluation of risk factors for complications after colostomy closure
Nuri Goret 1Ceren Goret 2Kenan Çetin 1Ahmet Agaçhan 1
Affiliations
Article Info
1 Department of General Surgery, Health Sciences University, Kartal Dr Lütfi Kırdar Research and Education Hospital, Istanbul, Turkey
2 Department of Surgical Pathology, Health Sciences University, Sancaktepe Research and Education Hospital, Istanbul, Turkey
Ann. Ital. Chir., 2019, 90(4), 324-329;
Published: 1 Jul 2019
Copyright © 2019 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
OBJECTIVE: The goal of the study is to describe postoperative complications observed after colostomy reversal and to define possible risk factor(s) for complication.s after colostomy closure PATIENTS-METHODS: Patients who underwent colostomy closure in Department of General Surgery, Dr Lutfi Kirdar Kartal Education and Research Hospital between January 2007 and January 2015 were enrolled. Patients with double-barrel ileo-colostomy, Devine’s colostomy and tube cecostomy were excluded from study. Demographics, data regarding the first operation and those regarding the reversal operation were analyzed and compared. RESULTS: Total 168 patients [118 (70.1%) male, average age=52.8±15.6] were included. Most common reasons for stoma formation were malignancy [n=63 (37.5%)] and diverticular perforation [40 (23.8%)]. Index operation was performed under emergency conditions in 142 (84.5%) patients. End colostomy was the most common stoma type in emergent cases and loop sigmoidostomy in elective cases. Postoperative complication was observed in 36 (21.4%) patients. Nine (5.3%) patients developed anastomotic leak. Of those, 8 (4.8%) was necessitated reoperation and 1 (0.6%) was treated conservatively. Postoperative mortality was 5 (2.9%). At multivariate analysis, DM was the independent risk factor for surgical site infection and evisceration (p<0.01). DM was present in 6 (66.7%) cases who had had an anastomotic leak and leak was more common compared to non-diabetics (p<0.05). Patients waiting more than 3 months before stoma reversal had experienced more anastomotic leak compared to those waiting less (p<0.05). CONCLUSION: Closure of colostomy has a significant morbidity and mortality, and the physician should be more careful in postoperative follow-up in patients who had comorbidities, especially diabetes mellitus.
Keywords
- Anastomotic leak
- Colostomy
- Postoperative complication