Problems of colostomy closure

Dolan, Patrick A.; Caldwell, Fred T.; Thompson, Carolyn H.; Westbrook, Kent C.

doi:10.1016/0002-9610(79)90142-9

Cited by 42 publications

(14 citation statements)

References 15 publications

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“…The mortality rate is 1%. 6 The results of this study show that this procedure can be performed under local anesthesia. Moreover, the levels of sedation, achieved by midazolam administered intravenously, were satisfactory and reduced the levels of anxiety generally felt by patients undergoing any type of surgical procedure.…”

Section: Discussionmentioning

confidence: 68%

Colostomy Closure Using Local Anesthesia

2001

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The feasibility of performing colostomy closures using local anesthesia was evaluated. The subjects comprised 14 patients: 2 with colostomies involving a mucous fistula and 12 with loop colostomies. Patients who had colostomies with mucous fistulas separated by 10cm or more were excluded from this study. All patients were graded as ASA 1 (according to the American Society of Anesthesiologists). The bowel was evaluated by colonoscopy in 6 patients and by barium enema in 8 patients. Bowel preparation was performed with Colayte and all patients were given prophylactic antibiotics. Closure of the colostomy was extraperitoneal and the time taken to perform the operation ranged from 40 to 120min. Tolerance was regarded as excellent in 9 patients, good in 3, and average in 2. There were 3 anastomotic leaks that resolved without further surgical treatment, 2 wound infections, and 1 bowel obstruction that was successfully treated with medication. Patients were discharged 2-22 days postoperatively, after a mean period of 9 days. Local anesthesia offers a safe and effective alternative to general or regional anesthesia for surgical closure of colostomies.

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Section: Discussionmentioning

confidence: 68%

Colostomy Closure Using Local Anesthesia

2001

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“…In the preoperative workup, we carried out a barium enema to determine the resolution of the inflammatory process and to exclude obstructive or concomitant disease [11,12]. However, for the younger ostomates with traumatic lesions, this study could have been ignored [12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…However, for the younger ostomates with traumatic lesions, this study could have been ignored [12][13][14][15][16]. The interval between the construction of the colostomy and its closure has been discussed for a long time and is believed to influence morbidity.…”

Section: Discussionmentioning

confidence: 99%

Delayed colostomy closure using the extraperitoneal method

Bozzo

Larrachea

2000

Tech Coloproctol

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Diverting temporary colostomy is usually closed within three months using an extraperitoneal technique. A study on loop colostomy closure protocol was carried out in 20 patients, in a period of 8 years, to restore the colonic transit at least three months after the stoma formation. The extraperitoneal technique was used. The colostomy closure was followed by complications in 7 cases (35%), of which only two were due to anastomotic dehiscence (10%). The presence of associated diseases increased morbidity. The delayed extraperitoneal colostomy did not carry a high postoperative complication rate. To achieve good results an accurate surgical technique is important.

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“…Stoma closure is currently a routine procedure with low mortality rate (0.5-1.0%) and morbidity rate of 10-50% Dolan P and Caldwell FT. 2 At our centre we have started using an alternative method of using local anaesthesia to overcome large number of patient load pending for reversal under general or regional anaesthesia, local anaesthesia has several advantages over general or regional anaesthesia, as its affects a limited area of the body, there is little interference with the function of other organs, it doesn't affect the respiratory function of the patients, there is minimal postoperative nausea and vomiting, the handling of intravenous fluids during surgery is made simpler, the immediate post-anaesthesia period is pain free. It is well tolerated by high risk patients Winnie A, Zsigmond E. 3 The aims of this study were to evaluate the feasibility of performing stoma reversal operation using local anaesthetic agents, to determine patient tolerance and safety of performing stoma reversal under local anaesthesia and to evaluate the short-term outcome of stoma reversal under local anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of feasibility and short term outcome of stoma reversal under local anaesthesia

Kumar

Singh

et al. 2017

Int Surg J

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Background: Stoma fashioning (ileostomy and colostomy) are very important and established procedures for deviation of bowel contents to procure the distal anostomosis. It is a very common procedure in cases of bowel obstruction, perforation, inflammatory bowel disease and large bowel disorders like Ca colon and Ca rectum, colonic fistulas, trauma to colon and rectum. Stoma reversal is a routine procedure but is usually performed using general or regional anaesthesia but large number of patient list for stoma reversal under general or regional anaesthesia, led to unnecessary delay in stoma reversal due to paucity of anaesthesia. Local anaesthesia has thus proved useful to handle a large load of stoma reversal, so we investigated feasibility of performing stoma reversal using local anaesthetic agent.Methods: Total 54 patients underwent for stoma reversal under local anaesthesia, admitted to Department of General Surgery, Nehru Hospital, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India.Results: Reversal of stoma could be comfortably done under safe dose of local anaesthesia, most of the patients remain comfortable intraoperatively, 4 out of 54 patients had systemic complications like vomiting and bradycardia and 2 had associated bowel injury. only 2 patients had minor anostomotic leak and 1 had developed fecal fistula while rest had normal intact anostomosis. Only 2 patients had reported moderate pain and 1 had mild pain according to visual analog scale and in 42 out of 54 patients had normal wound healing while 5 had minor erythema, 6 had seroma formation and 1 had complain of pus discharge.Conclusions: Reversal of STOMA can be performed safely and comfortably under local anaesthesia. Post op short term outcome and complications are comparable to that done under general or regional anaesthesia.

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Problems of colostomy closure

Cited by 42 publications

References 15 publications

Colostomy Closure Using Local Anesthesia

Colostomy Closure Using Local Anesthesia

Delayed colostomy closure using the extraperitoneal method

A prospective study of feasibility and short term outcome of stoma reversal under local anaesthesia

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