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결장루의 복원

Closure of the Colostomy

대한대장항문학회지 2000년 16권 6호 p.429 ~ 435
차수호 ( Cha Su-Ho ) - 광주기독병원 외과

김병석 ( Kim Byung-Seok ) - 광주기독병원 외과
문덕진 ( Moon Duk-Jin ) - 광주기독병원 외과
박주섭 ( Park Joo-Seok ) - 광주기독병원 외과

Abstract


Purpose: To investigate the timing of colostomy closure and the associated risk factors that affect the development of complication after colostomy closure.

Methods: We have reviewed and analyzed the results of 28 patients with colostomy closure at the Kwangju Christian Hospital from January 1993 to December 1997. We investigated to associated literatures on this subject for timing of colostomy closure, preparing a patient for colostomy closure, suture technique, wound management, underlying disease process related to the incidence of complication and experience of surgeons.

Results: Wound infection developed in 4 patients (14.4%). Anastomotic leakage occurred in one patient (3.6%). Small bowel obstruction developed in two patients (7.2%). Overall incidence of complication was 25%. The incidence of complications in patients with trauma who underwent colostomy was 44.4% and patients without trauma, 15.8%. Complication rate was 16.6% for loop colostomies and 40% for end colostomies. The morbidity was 40% for colostomies on the left side, 18.7% for transverse colostomies, and 0% for colostomies (2 ileostomies) on the right side. The morbidity rate for closures within 6 weeks for the initial operation was 50%; for those within 6 to 12 weeks, 8.3%; and for those after 12 weeks, 16.6%.

Conclusion: The optimal timing of closure varies from patient to patient, but closure within 6 weeks of the initial operation significantly increased the morbidity. Colostomies on the left side are associated with a higher morbidity rate than transverse colostomies or colostomies on the right side.

키워드

결장루 복원;합병증;복원 시기
Colostomy closure;Complication;Timing of colostomy closure
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