A prospective and randomized trial involving 35 rectal trauma patients who were colostomized, as part of their surgical treatment, was undertaken at the João XXIII Hospital, between November 1994 and June 1997. The aim of this study was to evaluate the early results colostomy closure in this patient population. Rectal trauma victims were assigned for two groups, according to their hospital number. Group 1: Early colostomy closure, on the 10th post-operative day, and Group 2, delayed closure, eight weeks after the initial operation. A contrast study of the rectum was performed in all patients prior to colostomy closure, in order to confirm the rectal healing. The majority were young male victims of penetrating trauma. All patients were submitted to a loop colostomy prior to the colostomy closure. The global complication rate after colostomy closure was 25.7%. Postoperative wound infection was the most commom complication (17.11%). Complications occurred in 35.7% of the cases in group 1 and 19.1% in group 2 (p = 0,423 ). We concluded that there was no significant difference between groups regarding complication rate, operative time for colostomy closure, and total hospital stay. Patients undergoing early closure (Group 1) stayed with a colostomy for an average of 10 days, while patients from delayed closure (Group 2) had their colostomy for an average of 66.3 days (p<0.001 - Kruskal-Wallis Test). Based on our findings, traumatic rectal injury victms who have a colostomy as part of their surgical treatment, may undergo early colostomy closure on the 10th post-operative day, as long as no complication of the initial operation is present.
Colostomies; Rectal injuries; Colostomy closure
