MORBIDITY OF ILEOSTOMY AND COLOSTOMY CLOSURE - IMPACT OF SURGICAL TECHNIQUE AND PERIOPERATIVE TREATMENT

The operative results and complications after stoma closure in 548 pat ients operated on between 1972 and 1993 are described in this retrospe ctive study. The patients were divided into three groups (group I, n = 74, 1972-1976; group II, n = 256, 1977-1985; group III, n = 218, 1986 -1993) according to the year of operation and changing concepts in col orectal surgery. The overall mortality rate was 2.0%, The morbidity ra te including minor complications was significantly reduced from 70.3% in group I to 27.1% in group III. Postoperative wound infections and f ever were the most common complications, The location of the stoma and the operative technique did not markedly influence the morbidity rate , The most striking decrease in complications was achieved by the comb ined usage of orthograde lavage and perioperative antibiotic treatment (14.6% wound infections, 6.9% postoperative fever), In conclusion, a standardized perioperative treatment protocol including orthograde lav age and antibiotics is recommended.