Complications of Colostomy

ABSTRACT

Although the creation of a colostomy is often regarded as a minor surgical procedure, complications and underlying diseases associated with colostomy creation alter the quality of life and the life-style of the patient significantly. One hundred forty-five patients underwent a colostomy at the Department of Surgery, Kangnam Sacred Heart Hospital, between 1987 and 1996. There were 83 males and 62 females, with a mean age of 52 years (range 1 year to 89 years). Sigmoid-end colostomies were performed most commonly (60.7%). The colostomies were performed predominantly for colorectal cancer (110 cases). Complications arising from the colostomy formation occurred in 45 patients (31%), with wound infection being the most common problem observed (16 cases). Colostomy revision was required in 4 cases. Patients with cecostomies had a relatively higher incidence of stomal complications (75%) when compared to those with other types of colostomies. Postoperative complications were more common after emergency operations than after elective operations. The complication rate for patients with obstructive colorectal cancer was higher than that of patients with non-obstructive colorectal cancer. Complications occurred in 3 patients of the 29 patients underwent colostomy closure(10.3%). The incidence of surgical complications was not related to the time interval between colostomy formation and closure. The mortality rate for colostomy formation was 2.7%, and the most common cause of death was sepsis. These results suggest that careful attention to technical details and intraoperative care in the case of emergency colostomy formation for obstructive colorectal cancer are necessary to reduce the risk of postoperative complications.