Early local complications following colostomy closure in cancer patients

Abstract

Early surgical complications following colostomy closure in 65 cancer patients operated on at the Istituto Nazionale Tumori of Milan [Italy] were evaluated retrospectively. The overall complication rate was 24.6%, including infections (13.8%), fistulas (6.1%), wound dehiscence (3.0%) and distal stenosis (1.5%). Type and rate of complications were analyzed to find a correlation with type, site and location of colostomy, technique of closure, presence or absence of drains or time interval between construction and closure of colostomy. No statistically significant association between the aforementioned factors and occurrence and rate of complications was found. Surgical attention, including meticulous manipulation of the stoma, avoidance of contamination of the wound, tension of sutures, dead spaces, collection of blood in the wound, and use of antibiotics and antiseptics, apparently are the most important principles in minimizing postoperative complications. [The majority of the colostomies were created to protect a difficult distal colonic anastomosis or after a major anastomotic leakage; in a few patients the colostomy was required before radiation or endoscopic treatment of rectal tumors.].