Evaluation of risk factors for complications after colostomy closure

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COD: 2933_29_11_2018_aop Categorie: , ,

Nuri Emrah Goret, Ceren Canbey Goret, Kenan Çetin, Ahmet Feran Agaçhan

Ann Ital Chir, Digital Edition 2018; 7
Ahead of Print – November 29

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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.

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