A colostomy is a surgical procedure that is performed on the colon in order to treat disease, an infection, severe trauma or blockage. A colostomy can be reversed and while it is a generally safe procedure when performed by a skilled and trained surgeon, there are certain risks and issues that the patient must consider carefully with the help of his doctor. Colostomy reversal complications are generally categorized as anesthesia-related or surgery-related.
Complications from anesthesia
To ensure the safety and comfort of the patient and an uninterrupted surgery, an anesthesiologist will administer anesthesia in order to numb the patient and prevent him from moving during the operation. Complications arising from the patient’s exposure to anesthesia are often rare, although allergic reactions may be experienced by some. Any complications related to anesthesia will occur during or after the surgery, such as spasms of the larynx and severe hypotension, a condition where the patient experiences a dangerous drop in his blood pressure.
Any concerns a patient might have regarding the use of anesthesia should be discussed with the surgical team. This is especially important if the patient has a history of allergic reactions or if a family member has had a bad experience related to anesthesia.
Colostomy has one of the highest risks of surgery-related wound infections due to the nature of the procedure. Patients who undergo open colostomy reversal are generally at higher risk than patients who receive laparoscopic or closed surgery. However, infection can be prevented as long as the wound is properly cared for. The wound at the incision site must be kept clean and dressed frequently in order to prevent the growth of harmful micro-organisms. Symptoms of an infection may include redness, swelling and pain, accompanied by a fever. If thick, foul-smelling fluid seeps out of the incision, the infection may be deeper.
Reaction to medications
Certain medications may be prescribed by the doctor in order to manage pain and prevent infection. Although medications are generally safe, some patients may experience adverse reactions. Should this occur, it is important to stop using the medication and seek the doctor’s advice immediately.
Reconnection site failure
The site of reconnection of the colon might not heal as expected, causing waste material to leak from the colon and travel to the abdominal cavity, increasing the risk of infection. This problem can only be corrected with surgery wherein another colostomy may be performed until the inside of the abdominal cavity can be cleaned and clear of any type of infection.
The site where the intestines were reconnected is known as an anastomosis. In some patients, a leak may develop in this area, increasing the risk of an infection. In mild cases, antibiotics may be prescribed to kill the bacteria. In moderate to severe cases, draining the leak and performing a corrective surgical procedure may be necessary.
Incontinence may be an inconvenient condition post-surgery but it is a troublesome complication nevertheless. The patient may feel frustrated and annoyed at his lack of ability to control his urination and/or bowel movements but the condition is often temporary and will resolve on its own after a few weeks’ time. In case this does occur, patients should practice frequent and proper personal hygiene procedures in order to prevent contaminating their immediate environment and avoid embarrassing social situations.
A hernia may occur on the area of the incision due to the weakening of the abdominal wall after the surgery. It may also be caused by an infection of the wound. A hernia is created when a part of the intestines gets pushed into the weak area and forms into a sac. If abdominal tissue slips into this sac, the patient may experience pain and other serious complications. Should this occur, additional surgery may be required to repair the bulge.
Development of scar tissue
In some patients, scar tissue may develop at the site of reconnection. If the scar tissue is significant enough, it could partially block or obstruct the colon, causing swelling and abdominal pain.
Ileus refers to the inability of the bowel to move, causing abdominal discomfort, bloating, constipation, nausea and vomiting, especially after eating. It is a temporary condition that is often treated by feeding the patient through an enteral feeding tube. Nasogastric tubes may also be placed in the stomach to stop food. Since the amount of food that enters the stomach and intestines is controlled, the bowel can rest and heal.
These are just some of the more common types of colostomy reversal complications that may be seen during and after surgery. There is always risk with any type of surgical operation and having a colostomy takedown is no different. In some instances if severe problems arise after surgery, a permanent colostomy may end up having to be performed.
A thorough consultation with the surgeon before the operation to discuss the procedure and possible risks and setbacks that may be encountered will help prepare the patient beforehand. Always inform your doctor or nurse or seek medical attention for any colostomy reversal complications that may be experienced after being discharged from the hospital.