Document Detail


A randomised study of colostomies in low colorectal anastomoses.
MedLine Citation:
PMID:  9449446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the value of covering colostomy for patients undergoing low anterior resection for rectal neoplasms. DESIGN: Prospective randomised study. SETTING: Two university hospitals, Finland. SUBJECTS: 38 patients with air-tight stapled end-to-end anastomoses and complete anastomotic tissue rings were randomly allocated to have a covering colostomy (n = 19) or not. MAIN OUTCOME MEASURES: Postoperative mortality, anastomotic leaks, reoperations for leaks. RESULTS: The clinical leak rate was 24% (9/38) and six patients (16%) had radiological leaks. The total number of leaks (clinical and radiological together) was similar in the two groups, 7/19 compared with 8/19, respectively. There were fewer clinical leaks in the colostomy group (3/19; 16% compared with 6/19; 32%), but the difference was not significant. Reoperations for leaks were necessary more often in patients who did not have a covering colostomy (6/19; 32% compared with 1/19; 5%, p = 0.09). Two patients who did not have a stoma died from the infective complications of their leaks and one died of heart failure in the colostomy group. One patient who had not been given a stoma initially was left with a permanent colostomy after a leak. CONCLUSIONS: Our results suggest that a covering colostomy does not reduce the leak rate after low anterior resection, but prevents most of the severe infective consequences of the leaks.
Authors:
T E Pakkastie; J T Ovaska; E S Pekkala; P E Luukkonen; H J Järvinen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The European journal of surgery = Acta chirurgica     Volume:  163     ISSN:  1102-4151     ISO Abbreviation:  Eur J Surg     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-04-08     Completed Date:  1998-04-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9105264     Medline TA:  Eur J Surg     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  929-33     Citation Subset:  IM    
Affiliation:
Second Department of Surgery, Helsinki University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical / methods
Colostomy*
Female
Humans
Male
Middle Aged
Postoperative Complications / epidemiology,  surgery
Prospective Studies
Rectal Neoplasms / surgery*
Reoperation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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