It is said that about 100,000 people in the US undergo Colostomy surgery every year due to an increased incidence of colorectal cancer and diverticulitis. Out of which two-thirds of the people undergo colostomy reversal surgery. Colostomy reversal surgery is carried out after temporary colostomy, which is done to give resting and healing time to the colon.

A lot of people are afraid of going for colostomy reversal surgery not because of the fear of operation again but because of the risk of complications associated with the procedure. How risky is colostomy reversal, it’s hard to answer right now as the risk is reliant on many factors.

In this article, we are going to reveal what colostomy reversal is and how risky it can be so that you can make an informed decision and lead a fulfilling life.

Understanding Colostomy Reversal:

Colostomy reversal, also referred to as colostomy takedown or colostomy closure, is a surgical intervention designed to undo a temporary colostomy. During this procedure, the section of the intestine previously brought outside the abdomen is repositioned back into the abdomen and reconnected with the rest of the intestine. However, before considering this process, your surgeon will thoroughly investigate the root causes that led to the necessity of the colostomy.

If the underlying causes have been mitigated, and the affected portion of the intestine has fully healed, only then will your surgeon opt for the colostomy closure procedure.

Reason for colostomy reversal:

Colostomy reversal is carried out at least after three months of temporary colostomy. Usually, temporary colostomy is performed in conditions like Diverticulitis, colorectal cancer, or inflammatory bowel disease, when the main purpose of colostomy is the give some time to the colon so that it gets healed completely. Once the affected part of the intestine heals completely which normally takes 3 to 4 months, your doctor will recommend you for colostomy reversal surgery.

Considerations for colostomy reversal:

Colostomy reversal is carried out on a person who is typically young and has good health. A doctor should consider the following factors in an individual before opting for colostomy reversal.

Complete Healing: The individual’s bowel should have healed completely from the initial condition that requires the need of the colostomy.
Disease-Free: The candidate should be free from any diseases and should not have any signs of inflammation or active infections.
Functional Anal Nerves and Muscles: The presence of functional anal nerves and muscles is crucial for the control of bowel movements.
Overall Health: The individual should be in good overall health, and robust enough to endure the pain and challenges associated with surgery.

If a patient possesses all these characteristics, they are considered a suitable candidate for the colostomy reversal procedure. However, the likelihood of a successful colostomy reversal is diminished if the patient:

is elderly patient
Has any form of cancer.
Suffers from ischemic heart attack or angina.
Has ischemic bowel.

These factors can increase the risks associated with the surgery and may impact the overall success and recovery of the colostomy reversal. It is crucial for the medical team to carefully assess each patient’s health status and consider these factors before recommending or proceeding with the colostomy reversal procedure.

Risks Associated With Colostomy Reversal:

Anastomosis:

One major issue that can occur after colostomy closure is called an Anastomotic leak. While it’s rare, it happens when the parts of the bowel are stitched together. To put it simply, it means that the joining of the two ends of the bowel is not done properly, leading to leakage of bowel contents into the abdominal cavity. This could be serious, as bacteria from body waste might enter the bloodstream, causing a severe blood infection called sepsis.

Weak Abdominal Muscles and Hernia:

Repeated surgeries can weaken the abdominal muscles, increasing the chance of developing a hernia at the operation site.

Abdominal Adhesion:

Sometimes, tissues in your abdomen stick together, forming bands of scar tissue. Usually, they don’t cause any problems, but occasionally, they can lead to a blockage in your bowel. In such cases, they should be removed.

Trouble Controlling Bowel Movements:

Some people may experience fecal incontinence due to uncoordinated or weak anorectal muscles. In such instances, your surgeon may recommend physiotherapy to help strengthen the weak muscles.

Other than all these, you may experience some short-term side effects as well which include:

Discomfort: It’s common and usual to feel discomfort at the site of surgery. The same goes with colostomy reversal, patient might feel soreness and tenderness along with the feeling of discomfort in the abdomen.

Paralysis of the intestinal muscles: Just like discomfort, paralysis of the intestinal muscles is also a common side effect after surgery. Your healthcare team will guide you about it.

Changes in stool: Some patients may experience diarrhea whereas some experience constipation. This is due to the loss of tonicity of muscles and nerves as they were not functional. Also swelling from surgery may cause changes in the stool.

How Dangerous Is Colostomy Reversal:

Colostomy reversal is just like a double-edged sword. It gives you benefits by getting rid of the colostomy bag but at the same time, there are chances of risk and complications associated with it.

Anastomotic leakage is a dangerous complication associated with it. and the reason for anastomotic leakage

is improper joining of the two ends of the intestine that may lead to serious complications that as blood infection or sepsis which is a life-threatening condition. To overcome this situation, reoperation is carried out to re-seal the two ends of the intestine. Usually, reoperation is carried out via laparoscopy technique.

So there are risks and benefits associated with the reversal process.

a research study was conducted to determine the mortality and complications associated with the colostomy reversal technique. 116 patients participated in the research study out of which only 12 patients who underwent colostomy reversal developed any complications. it was concluded from the study that colostomy reversal is a safe surgical procedure with low mortality and morbidity rates.

Benefits of colostomy reversal:

Restoration of Normal Bowel Function:

One of the primary benefits of colostomy reversal is the restoration of natural bowel function. Patients can return to a more typical lifestyle without the need for a colostomy bag.

Improved Quality of Life:

Colostomy reversal often leads to improved quality of life for patients, as they regain control over their bowel movements and experience fewer limitations on daily activities.

Psychological Well-being:

The removal of the colostomy bag can have a positive impact on a patient’s mental and emotional well-being. Many individuals experience increased self-esteem and a sense of normalcy after the reversal.

Conclusion:

Colostomy reversal is generally a safe and effective procedure. this life-saving intervention offers patients the opportunity to return to a more normal way of life. colostomy reversal is not at all a dangerous procedure. However, like any surgery, it comes with potential risks and complications. Depending upon your health and physical well being your surgeon will make an informed decision about colostomy reversal. Also, the expertise of your surgeon matters a lot in decreasing the risks associated with the reversal process.

In simple terms, getting a colostomy reversal is like taking back control of your body and your life. As you go through this process, you’re not just healing your body but also showing the world the strength that’s always been inside you.

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197143/

https://www.jrmds.in/articles/mortality-and-morbidity-after-colostomy-reversal-among-patients-admitted-in-surgical-department-88710.html

https://www.healthline.com/health/life-after-colostomy-reversal

https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1130&context=pakistan_fhs_mc_surg_surg