Summary
The postoperative course of 104 patients, who underwent closure of a transverse loop colostomy at the Surgical Department of the Teaching Hospital Herford between 1974 and 1980 after distal resection and anastomosis of the large bowel for neoplastic or diverticular disease has been reviewed in detail. The mortality was 0.9% and the morbidity rate was 25%, including 25% wound infections and 4.8% fecal fistulas. The highest complication rate was noted, when colostomies were closed during the first 6 weeks. Wound infections and fecal fistulae did not occur more frequently than in patients with diverticulitis. The intraperitoneal procedure of transverse loop colostomy closure can be recommended as to be straightforward and safe.
Zusammenfassung
Es wird über 104 Patienten berichtet, die in der Zeit von 1974–1980 an der Chirurgischen Klinik des Lehrkrankenhauses Herford wegen ihres operativen Verschlusses der Transversumfistel stationär behandelt wurden. Die Transversumfistel war in der Mehrzahl der Fälle bei der Resektion einer Sigmadiverticulitis oder wegen Colon-Rectumcarcinoms angelegt worden. Die Mortalität betrug 0,9% und die Morbidität 25%. Hierbei handelte es sich in 25% der Fälle um Wundheilungsstörungen und in 4,8% der Fälle um Stuhlfisteln. Die Komplikationsrate lag bei jener Patientengruppe am höchsten, bei denen die Colostomie innerhalb der ersten 6 Wochen nach der Anlage wieder verschlossen wurde. Das Auftreten von Wundheilungsstörungen und Stuhlfisteln war nicht signifikant höher bei der Patientengruppe mit Sigma-Diverticulitis. Der intraperitoneale Verschluß der doppelläufigen Colostomie im Bereiche des Colon transversums kann als ein sicheres operatives Verfahren empfohlen werden.
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Auszugsweise vorgetragen auf dem 6. Weltkongreß des CICD, Lissabon 1980
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Wedell, J., Meier zu Eissen, J., Störmer, J. et al. Die Morbidität und Letalität des intraperitonealen Verschlusses der doppelläufigen Transversumfistel. Langenbecks Arch Chiv 356, 17–24 (1982). https://doi.org/10.1007/BF01270598
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DOI: https://doi.org/10.1007/BF01270598