A colostomy is a life-saving intervention whose main purpose is to give time to the colon to rest and heal properly. Once the colon gets completely healed and the patient’s conditions have improved then it’s time for the next intervention which is colostomy reversal.
Colostomy reversal is carried out to restore the normal continuity of the digestive tract. Though it is a very simple surgical procedure its success rate varies depending upon the initial reason for colostomy. This article talks about colostomy reversal and the success rate of colostomy reversal. Remember, not everyone who has colostomy will have the option of colostomy reversal, some people will have to live with colostomy for their entire life.
What is Colostomy Reversal?
Colostomy reversal also known as colostomy takedown or colostomy closure is a surgical procedure to reverse the temporary colostomy. that means the part of the intestine that was brought outside the abdomen will now be sent back into the abdomen and connected with the rest of the intestine. but before opting for this procedure your surgeon will examine the underlying causes that lead to colostomy. If that cause has subsided and the injured part of your intestine has healed completely, only then he will opt for a colostomy closure procedure. conditions in which temporary colostomy is created are:
- colorectal cancers
- inflammatory bowel disease
Usually, in many people, colostomy reversal is carried out 3 months after the colostomy surgery.
Read More: What are colostomy bags used for?
How is colostomy reversal carried out?
Colostomy reversal is a very simple surgical procedure. it takes less time than the colostomy procedure.
Closure surgery of loop colostomy is carried out as an open procedure. The surgeon creates a small cut in the skin around the stoma and keeps cutting until reaches deep down the abdominal cavity. The surgeons will examine the bowel and abdominal cavity. He then closed the hole that was brought outside during stoma creation with the help of sutures and staples. If it’s a simple case, the whole process takes around 30-45 minutes. but it could extend up to 2 hours if excessive adhesions are found from colostomy surgery.
On the other hand, closure surgery of end colostomy is a laparoscopic procedure that requires 1 to 3 hours to attach the remaining sections of colons.
Usually, general anesthesia is given during the procedure and your surgeon will keep you on fast for around 6 to 8 hours before starting the procedure.
Related: Reasons for a colostomy bag
Who is an ideal candidate for colostomy reversal?
An ideal candidate for colostomy reversal surgery should be young and healthy and should possess the following characteristics.
- His/her bowel should be healed completely.
- He/she should be disease-free and don’t have any inflammation or active infection.
- He/she should have functional anal nerves and muscles to control the bowel movements.
- overall, he/she should be healthy and fine enough to bear any other surgery pain.
If patients possess all these characteristics, then he is a suitable candidates for colostomy reversal procedures.
However, chances for colostomy reversal would be less, if:
- The patient has any kind of cancer.
- Patient suffers from Ischemic heart attack or angina.
- Patient has ischemic bowel.
- or the patient is geriatric.
Read More: Pain after ileostomy reversal
Complications associated with colostomy reversal technique:
One of the biggest complications associated with the colostomy takedown procedure is an Anastomotic leak. Though it’s a rare complication but it occurs at the point where parts of the bowel are joined together. in simple words, this means improper sealing/joining of two ends of the bowel that leaks the content of the bowel into the abdominal cavity. this could have serious consequences, as bacteria from the body waste could enter the bloodstream and cause serious blood infections called sepsis.
Due to repetitive surgeries, abdominal muscles get weak and there could be a possibility of developing a hernia at the site of the operation.
Sometimes tissue in your abdomen sticks together to form bands of scar tissue. usually, they do not cause any problems, but they sometimes cause blockage in your bowel., therefore they should be removed.
Due to uncoordinated or weak anorectal muscles, some people may have fecal incontinence. for this, your surgeon will recommend physiotherapy to help restore the weak muscles.
Success Rate Of Colostomy Reversal Procedure:
Ostomy reversal surgery typically has a high success rate, as indicated by numerous studies reporting rates between 70% and 95%. Success is commonly defined by the effective closure of the stoma and the restoration of regular bowel function.
the success rate of colostomy reversal depends upon several factors such as:
Patient’s Health Status:
The overall health of the patient plays a crucial role in the success of colostomy reversal. Patients with good general health are more likely to have positive outcomes. if the patient has any other disease state, such as cardiovascular disorders, then there would be less likelihood of successful colostomy reversal.
Reason for Colostomy:
The underlying reason for the initial colostomy can impact the success of the reversal. Conditions such as colorectal cancer, diverticulitis, or trauma may influence surgical outcomes. since colostomy was created due to these conditions to give healing time to the colon.
Type of Colostomy:
– The type of colostomy initially performed can affect the success rate. Temporary colostomies, which are created for specific conditions and intended to be reversed, generally have higher success rates compared to permanent colostomies. Also, reversal after End colostomies or Hartmann’s procedure has less success rate than loop colostomy. not only this, but chances of complications are also more associated with reversal after Hartmann’s procedure.
Time Since Colostomy Creation:
The duration between the creation of the colostomy and the reversal surgery can influence outcomes. In some cases, a longer duration may lead to changes in the anatomy and function of the intestines, affecting the success of the reversal.
The skill and experience of the surgeon performing the colostomy reversal are crucial factors. A skilled surgeon is better equipped to handle potential complications and ensure a successful outcome.
Even when colostomy reversal is successful, there’s a high chance of problems like failure and infections. Because of this, many people who initially get temporary colostomies choose to keep it and not have the stoma reversed.
Recovery After Colostomy Reversal Procedure:
after colostomy reversal surgery, you will have to stay in the hospital for 3 to 4 days. Stay could be longer in case of reversal after the end of colostomy. The purpose of this stay is to check whether the wound is healed completely and whether the patient is passing stool normally or not. Usually, bowel functions return to normal in about 1 to 3 days after the surgery.
You can eat or drink whatever you want once your bowel’s normal function has been restored. Remember to eat a balanced diet it will help you in a fast recovery.
Usually, it requires a month to heal after the reversal of a loop colostomy whereas, after the reversal of Hartmann’s’ procedure it requires at least 2 months to heal completely.
Your healthcare team will give you specific instructions for your diet and wound care based on the type of reversal you had and any other health issues you might have.
The journey from a life-saving colostomy to the decision of reversal involves careful consideration, with the success of the latter dependent on various factors on which the patient’s overall health is at the top. The majority of colostomies are done with the intention of reversal in mind, but fear of surgery and the high risk of infection prevent people away from colostomy reversal surgery. let me tell you, the Colostomy reversal procedure is not at all a dangerous process, rather it’s a simple process to bring your body back to normal function. you should have a detailed discussion with your surgeon about the potential risks, benefits, and outcome of colostomy reversal keeping in view your disease condition. Remember, the collaboration between patients and their healthcare team is vital in achieving the best possible outcomes.