From the Research
A colonoscopy is generally recommended before colostomy reversal surgery to ensure the colon is healthy and free from complications. This procedure allows surgeons to examine the entire colon and detect any new issues that might complicate the reversal, such as strictures, inflammation, recurrent disease, or new polyps 1. The examination helps confirm that the distal segment of the bowel (the portion that was bypassed during the original colostomy) is healthy, patent, and free from leaks or obstructions.
Some key points to consider when deciding on a colonoscopy before colostomy reversal include:
- The ability to detect synchronous lesions or other complications that might affect the outcome of the reversal surgery
- The potential to reduce morbidity and mortality by identifying and addressing issues before the reversal
- The importance of direct visualization of the bowel to assess its health before reconnecting the intestinal segments
While some studies have compared the effectiveness of different diagnostic tools, such as CT colonography and barium enema, the most recent and highest quality study suggests that colonoscopy is the most comprehensive assessment of bowel health before reconnecting the intestinal segments 1. The preparation for this colonoscopy is the same as standard colonoscopy prep, involving bowel cleansing with solutions like GoLYTELY, MoviPrep, or similar products the day before the procedure.
It's worth noting that some surgeons might proceed with reversal without a colonoscopy in certain emergency situations or when recent imaging provides sufficient information. However, the direct visualization offered by colonoscopy provides the most comprehensive assessment of bowel health before reconnecting the intestinal segments. Typically, the colonoscopy is performed 2-4 weeks before the scheduled reversal surgery, allowing enough time to address any issues that may be detected during the examination.