A colostomy is a surgical procedure in which an opening is made in the abdominal wall and connected to the intestine beneath the stomach. The opening allows fecal material to exit the body without travelling through the rest of the digestive tract. A colostomy reversal, also called a laparoscopic colostomy reversal, is a surgical procedure that reconnects the stomach and intestines, restoring normal function to the digestive system. Colostomy reversals are common procedures but can result in significant complications.
Colostomies are necessary for patients with a variety of intestinal and colon problems that prevent them from being able to digest and excrete their food properly. Some conditions for which colostomies are performed include diverticulitis (inflammation and sometimes infection of the intestines), cancer, Crohns disease, intestinal obstruction and birth defects, according to the National Digestive Diseases Information Clearinghouse. For many of these conditions, the colostomy can be temporary. In these cases a reversal can restore normal function to the patient’s digestive tract.
Colostomy reversals are major surgical procedures that carry with them all of the risks associated with general anaesthesia and surgery. Some patients are allergic to anaesthesia and experience life-threatening reactions. Infection is a common concern during any surgery but those undergoing abdominal surgery are particularly susceptible, according to the journal World of Surgery.
Open Colostomy Reversal Risks
An open colostomy reversal (as opposed to a laparascopic reversal) carries high rates of wound infection, according to the Journal of Gastrointestinal Surgery. In a controlled study of the two surgical procedures, 59 per cent of patients receiving open colostomy procedures had some level of infection, while only 14 per cent of patients receiving laparascopic surgery experienced infection. Open colostomy reversal can also result in anastomotic leak (a colostomy that remains partly open) and incisional hernia, a herniation of the incision site.
Closed Colostomy Reversal Risks
Closed or laparoscopic colostomy reversals involve the use of cameras inserted through small incisions. Laparascopic surgery eliminates the need for large incisions. Large incisions in the abdomen take a long time to heal and can easily get infected. According to the Journal of Gastrointestinal Surgery, laparoscopic colostomy reversals result in lower post-operative morbidity, though they still carry the risk for complications such as infection, incontinence and anastomotic leak. Unfortunately it is not possible to perform this kind of surgery for all patients. Patients with complex wounds may need traditional surgery.
While it is not life-threatening, incontinence can be an upsetting condition for many people. Some colostomy reversals leave the patient unable to control his bowels as well as before, and can affect the frequency of elimination and the consistency of stool, according to the National Digestive Diseases Information Clearinghouse.