The left transverse colostomy.

The right transverse colostomy is the one traditionally performed for distal colonic obstructive tumors, perforated sigmoid diverticulitis, distal colonic injuries, or for the protection of precarious low colonic anastomoses. However, the right transverse colostomy has a tendency to prolapse; its effluent is frequently liquid; it cannot be performed without producing adhesions in the right upper quadrant; and it obligates the surgeon generally to three operations when done as the first part of a staged colonic resection. The left transverse colostomy has the advantages of a reduced incidence of prolapse, an increased length of absorptive surface, absence of adhesions in the right upper quadrant, and the possibility of a two-stage resection. Fifteen instances in which left transverse colostomies were performed with diverse indications formed the basis for this report.