Research Article

Timing of Hartmann’s Colostomy Reversal and Necessity of Mechanical Bowel Preparation in Patients Undergoing Urgent Left-sided Colonic Surgery

  • Alper Akcan
  • Erdoğan Sözüer
  • Hızır Akyıldız
  • Can Küçük
  • Mehmet Çetin

Turk J Colorectal Dis 2007;17(2):82-87

INTRODUCTION:

Timing for colostomy closure and mechanical bowel preperation (MBP) need are still controversial in patients who had urgent Hartmann’s colostomy (HC) for leftsided colon diseases. In this study we aimed to investigate the timing and MBP need in these emergent operations.

METHODS:

A total of 112 patients who had HC and after closure between January 2000 and May 2007 were the study group. Patients were divided into four groups according to timing for colostomy closure. Group 1 had HC in first 60 days, group 2 in 61 to 120 days, group 3 in 121 to 180 days, finally group 4 in more than 180 days.

RESULTS:

Mean age of group 4 was significantly different from other groups (p=0.001),but sex, concomitant diseases and neoplastic courses were not different (p>0.05). The most often complications were pulmonary ones, and wound infections were the most often surgical complications. Medical and surgical complication rates of the groups were not different (p>0.05). When compared, the durations of intensive care unit (ICU) stay were not statistically different (p>0.05), but mean total hospital time was longer in group 4 than groups 1 and 2 (p>0.05).

DISCUSSION AND CONCLUSION:

Our results show that colostomy closure can be performed in less than two months without MBP. Our patient groups were non-homogenous and study is retrospective, so prospective and randomised studies should be performed on this subject.

Keywords: Hartmann’s colostomy, timing, mechanical bowel preparation