INTRODUCTION: Transverse colostomy (TC) is a surgical procedure used to protect a low colorectal or coloanal anastomosis. The aim of this study was to evaluate the risks and benefits of a temporary mucocutaneous TC.
METHODS: 83 patients (56 males, 27 females) with TC were retrospectively reviewed. The indications for fecal diversion included colorectal carcinoma (27) 32.5%, diverticulitis (9)10.8%, megacolon (8) 9.6%, colovesical fistula (7) 8.4%, stab (2)2.4%, gynecological cancer (1)1.2%, Fournier Syndrome (1) 1.2%, colonoscopic perforation (1)1.2%, foreign body perforation (1)1.2%, and traumatic perforation (1)1.2%. 24-48 hours after surgery the rod was removed after 1-3 months. The TC was reversed under local anesthesia using one layer of extramucousal suture in an extraperitoneal fashion. We reviewed the mean age, length of time, early and late complications.
RESULTS: No complications were noted during construction of the TC; the mean length of operative time was 25 (15-45) minutes. Early complication occurred in 1 patient (ileus) and late complications occurred in 3 patients (3 parastoma hernias). All 3 hernias were repaired at the time of reversal. One patient had a segment resection due to injury to the posterior wall during TC reversal. After reversal, 9 patients had wound infection, and 1 patient had a fistula that was successfully clinically managed.
CONCLUSION(S): TC is an option to protect a low colorectal or coloanal anastomosis. The positive results should be further evaluated compared to loop ileostomy. parastomal hernias, the most frequent complication, can be repaired at the time of TC reversal.
Program Number: P149