Loop transverse colostomy. The case against

Abstract

All large-bowel stomas (198) performed between 1970 and 1980 in a community hospital were reviewed. Twenty-nine stomas were loop transverse colostomies. There were five deaths, a complication rate related to the stoma of 28 per cent, and only 18 patients ever achieved colostomy closure. Our conclusions are as follows: (1) transverse colostomy is a holdover from the past; (2) "temporary" loop colostomy is a misnomer; (3) all colostomies should be end-bearing and matured primarily; (4) blind surgery invites tragedy; (5) loop transverse colostomy is a risky first stage with little benefit; (6) every colostomy should be placed as near as possible to the disease process; and (7) resection of the disease is the ideal first stage.