Early complications and associated risk factors of colostomy reversal at St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia, 2020

Abstract

Abstract Introduction: Colostomy creation is a lifesaving procedure performed in the settings of complicated colonic volvulus, colonic trauma and obstructing colonic cancer etc. When temporary, it needs to be reversed to restore normal colonic function. Collected information is lacking regarding the outcomes of colostomy reversal in Ethiopia. Objective: It was to determine the early post-operative complications and associated risk factors of patients who underwent colostomy reversal at St. Paul’s Millennium Medical College, SPHMMC, Addis Ababa, Ethiopia, 2020. Methodology: A retrospective review of all patients who underwent colostomy reversal from September 2016 to August 2019 at St. Paul’s Hospital Millennium Medical College (SPHMMC) was conducted from February 4- May 30, 2020. Both qualitative and quantitative data was collected using a structured data extraction format and analyzed using SPSS 25. Results was presented in tables, figures and statements. Results A total of eighty-three patients who underwent colostomy reversal were identified during the four-year period. The majority of patients were male 56 (67.5%) with mean age 42.08 years (SD – 18.18). Hartman’s and loop colostomy were the types of colostomies performed 61 (73.5%) and 22 (26.5%) respectively. Nearly three fourth of the patients, 74 (89.2%), their colostomies were reversed after 12 weeks and Only a quarter of the patients got their colostomies closed between 6-12 weeks. The total number of complications seen were 20(24.1%). The most common complication was wound infection developed in 10 patients, followed by wound dehiscence in 3 patients, anastomotic leak and venous thromboembolism occurred in 2 patients each. One patient who was initially operated for gangrenous sigmoid volvulus and later underwent Hartman’s colostomy reversal developed pulmonary embolism had died, making the overall mortality rate 1.2%. Conclusion Restoration of intestinal continuity was associated with significant morbidity however the vast majority of this were superficial surgical site infection which was easily managed. Therefore, colostomy reversal in our setup has a good overall surgical outcome with 1.2% mortality.