Failure of the unopened colostomy to protect high-risk rectal anastomoses.

Abstract

Abstract Anastomotic breakdown, the most serious complication of restorative rectal resection, is responsible for half the postoperative morbidity rate and one-third of deaths1. While many surgeons defunction low anastomoses2, others consider this unnecessary3. A tube caecostomy can be used after on-table orthograde bowel lavage to avoid a stoma4. An obstructing unopened loop ‘colostomy’ offers potential advantages5. It can be returned to the abdomen if the anastomosis heals soundly or opened into a colostomy if it leaks. This method was evaluated in seven patients.