ABSTRACT
In 1783, Dubois is said to have been the first to construct a colostomy in an infant, but the patient, who had anal atresia, died after 10 days. The first long-term survivor was an infant, also with imperforate anus, who had a colostomy made by Duret in 1793 and was still alive 45 years later. With the Mikulicz technique, the common walls of a double-barreled colostomy are crushed using an enterotome or forceps, and the resulting fecal fistula is closed later, leaving the suture line extraperitoneal if desired. Today, colostomy formation and closure are safe operations provided basic surgical principles are adhered to, but the risk of potentially serious complications is ever-present and must not be underestimated. A right upper transverse incision is used for a transverse colostomy; a transverse muscle-sparing incision is used for a sigmoid colostomy, centered about midway between the umbilicus and the left anterior superior iliac spine.
