DEFUNCTIONING COLOSTOMY FOR LOW ANTERIOR RESECTION - A SELECTIVE APPROACH

Seventy-seven consecutive low anterior resections of the rectum were p erformed with a selective approach to the use of a defunctioning colos tomy. A defunctioning colostomy was performed in seven patients (9 per cent) where there was concern about the anastomosis due to difficult dissection (three), incomplete doughnuts (three) and tension on the an astomosis (one). The mean level of the tumour in the defunctioned grou p was 7.6 cm. Clinical anastomotic leakage occurred in two patients (3 per cent) in the non-defunctioned group, both of which were controlle d with subsequent transverse colostomies. There were no perioperative deaths. Selective defunctioning of low colorectal anastomoses can prod uce low rates of anastomotic dehiscence while reducing the morbidity a ssociated with a temporary stoma.