Cierre de colostomía por laparoscopia en trauma abdominal por proyectil de arma de fuego

Abstract

The return of intestinal transit after colostomy, is associated with alonger hospital stay and high morbidity, with some cases of mortality. Repeated trauma of the abdominal wall exposes patients to infections, pain and adherence syndrome. The use of
minimally invasive surgery, chest physiotherapy, and early nutrition with fast absorbing formula enriched with glutamine, reduces morbidity in these patients.

This paper presents two consecutive patients between December 2010 and March 2011 who underwent laparoscopic colostomy closure after abdominal trauma due to gun shot trauma, the first case, a Hartmann colostomy was required to spare the rectum after trauma, and the second case, a Devine colostomy was required due to hemodynamic instability and the severity of the trauma that compromised multiple systems and the transverse colon. We describe the surgical process of restitution of colonic transit and post-operative care to reduce morbidity of these patients.