Morbidity and mortality following intraperitoneal closure of transverse loop colostomy

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Abstract
A retrospective analysis of 153 patients having i.p. closure of transverse loop colostomies was performed. The mortality was 1.4%. The morbidity rate was 15%, including 7% wound infections and 5.2% fecal fistulas. The incidence of wound infection was not significantly improved by the use of systemic or nonabsorabable intestinal antibiotics. I.p. drainage alone or in combination with s.c. drainage resulted in the highest rate of wound infection. The use of i.p. drains seems justified for the control of fecal fistula if it should occur. The lowest incidence of complication was noted when colostomies were closed in 2-4 mo. Particular attention must be given to cases with diverticulitis as these have a greater morbidity. Factors which reduce morbidity are directly related to clean and careful dissection of the bowel with a sound technique of anastomosis.

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