Same admission colostomy closure: A prospective, randomised study in selected patient groups

Background: Despite a recent trend towards primary repair, colostomy still has an important place in the management of different colorectal pathologies. Timing of colostomy closure is a debatable issue among general surgeons. We carried out a prospective, randomised study to compare the outcome after same admission colostomy closure (SACC) and conventional delayed colostomy closure (CDCC) in patients with predominantly traumatic injury of the large bowel. Methods: Sixty patients, the majority with traumatic colorectal pathologies, were prospectively randomised to SACC [30 patients, 23 men, mean age 27.9 ± 9.7 (range, 18-65) years] or (CDCC) [30 patients, 24 men, mean age 28.6 ± 10.6 (range, 18-63) years]. All colostomies were closed using an intraperitoneal closure technique. Pre-operative data and post-operative outcomes were collected and analysed. Results: A total of seven patients (23.3%) with SACc developed complications compared with eight patients (26.6%) having CDCC (p=0.83). The mean hospital stay (p<0.01), as well as the overall cost (p<0.001), were significantly less in the SACC group. Conclusions: Same admission colostomy closure is a safe and cost-effective technique for colostomy closure in selected groups of patients