The unopened colostomy: a procedure to protect colonic anastomosis

The results of an alternative to the classic diverting lateral colostomy when used to protect a high risk anastomosis are reported. Fourteen out of 122 patients undergoing colonic or colorectal resection had a restoration of intestinal continuity with a proximal closed loop colostomy--of these 11 did not require opening in the immediate post-operative period. These had an uneventful early post-operative course, and the return of the colostomy to the abdominal cavity was performed within 10 days post-operatively, without having been opened. In three cases where local or general complications occurred, the opening of the colonic loop led to the creation of a conventional temporary protective colostomy. This procedure allowed a reduction of the originally planned number of colostomies by 50%.