Complications of median versus lateral colostomy

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The purpose of this study is the evaluation of early and late complications in two groups of patients: 143 patients with lateral colostomy and 68 patients with median colostomy.

Patients were followed for periods ranging from three months to three years. Early complications included skin irritation, bleeding, ischemia, infection, and retraction.

Late complications included hernia, prolapse, and stenosis.

From the analysis of the case series, the authors conclude that (1) double-barreled colostomies have a higher complication rate than do simple colostomies; (2) after double-barreled colostomy, late and early complications occur more frequently if the site of the stoma is midline; (3) with regard to terminal colostomies, the incidence of complication varies-bleeding, stenosis and retraction appear to be more frequent in median stoma, while prolapse occurs more frequently in lateral stoma.

No difference, was found in the percentage of surgical revisions. The authors prefer to place the stoma in the left lower quadrant, of the abdomen, since, after median laparotomy, a lateral colostomy has less risk of stenosis.

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