Closure of Temporary Colostomy
There are reports in the surgical literature—Wheeler and Barker, Knox et al., and Yaiko et al. among them—describing many complications and even mortality following operations for closure of a colostomy. In many instances it is emphasized that the complications are more numerous when a colostomy is closed before 30–90 days have passed after the formation of the colostomy. On the other hand, we have had excellent results even when colostomies were closed 2–3 weeks after the initial operation. The discrepancy exists because all of our colostomies were immediately matured by mucocutaneous suture. Most of the authors who report complications from colostomy closure and who require the passage of 30–90 days to make closure safer do a loop colostomy over a glass rod. If immediate mucocutaneous suture is not done, several weeks must elapse before granulation and contraction results in spontaneous maturation of the colostomy. Because this type of colostomy often is accompanied by considerable fibrosis and inflammation, the surgeon should indeed wait 60–90 days before attempting closure. Turnbull and Weakley agree that when the colostomy has been matured by mucocutaneous suture at the initial operation, the colostomy closure may take place whenever indicated by the patient’s condition. Also, in our experience the matured colostomy can generally be closed without the need to resect and anastomose a segment of colon.
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- Turnbull RB Jr, Weakley FL (1967) Atlas of intestinal stomas. Mosby, St. LouisGoogle Scholar