대한대장항문학회

Purpose: To investigate the timing of colostomy closure and the associated risk factors that affect the development of complication after colostomy closure. Methods: We have reviewed and analyzed the results of 28 patients with colostomy closure<br>at<br>the<br>Kwangju Christian Hospital from January 1993 to December 1997. We investigated to associated literatures on this subject for timing of colostomy closure, preparing a patient for colostomy closure, suture technique, wound management, underlying<br>disease<br>process related to the incidence of complication and experience of surgeons. Result: Wound infection developed in 4 patients (14.4%). Anastomotic leakage occurred in one patient (3.6%).<br>Small bowel obstruction developed in two patients (7.2%). Overall incidence of complication was 25%. The incidence of complications in patients with trauma who underwent colostomy was 44.4% and patients without trauma, 15.8%. Complication rate<br>was<br>16.6%<br>for loop colostomies and 40% for end colostomies. The morbidity was 40% for colostomies on the left side, 18.7% for transverse colostomies, and 0% for colostomies (2 ileostomies) on the right side. The morbidity rate for closures within 6 weeks<br>for<br>the<br>initial operation was 50%; for those within 6 to 12 weeks, 8.3%; and for those after 12 weeks, 16.6%. Conclusion: The optimal timing of closure varies from patient to patient, but closure within 6 weeks of the initial operation significantly<br>increased<br>the morbidity. Colostomies on the left side are associated with a higher morbidity rate than transverse colostomies or colostomies on the right side.<br>