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At least 235 records · Page 13Linked to original sources
PubMed1990

Dermatologic complications in colostomy and ileostomy patients.

This study was designed to determine the prevalence and type of peristomal skin complications in ileostomy and colostomy patients. The influence of sex, race, age, and stoma location as possible risk factors for developing these conditions was examined. A chart review in combination with a telephone survey was conducted. The population included all ileostomy and colostomy patients (362) who had their procedure between January 1, 1984 and December 31, 1985 at the Mt. Sinai Hospital in New York. Ninety-three patients were ultimately surveyed. There were 58 ileostomy and 35 colostomy cases. This study concluded that there may be a direct relationship between age and peristomal skin problems; gender is not a risk factor for acquiring these conditions in ileostomy (p greater than 0.7) or colostomy (p greater than 0.3) patients; most patients seek the enterostomal therapist for treatment of peristomal skin problems; and the most common peristomal skin condition is minor to moderate skin irritation with redness. It is recommended that both the health professional managing the ostomy patients, and the ostomy patients themselves, receive more education concerning the techniques and the importance of proper stoma care. Future studies examining the role of the dermatologist with regard to these problems are recommended.

Adolescent↗
PubMed2005

Evaluation of the end colostomy complications and the risk factors influencing them in Iranian patients.

INTRODUCTION: The aim of this study was to assess the prevalence of end colostomy complications and the evaluation of factors influencing outcome. PATIENTS AND METHODS: Three hundred and thirty patients with end colostomy were studied. All patient were recalled for examination for recent complications. Early complications included stoma site pain, early dermal irritation (during the first month after surgery), mucosal bleeding, stomal prolapse and psychosocial complications. Late complications included peristomal hernia, stomal stenosis, late dermal irritation (after the first month), stomal retraction, stomal necrosis and other stoma complications (perforation, fistula etc.). Probable underlying factors were studied. To evaluate risk factors affecting complications, univariable analysis and then multivariable analysis by binary logistic regression was performed. RESULTS: One hundred and one (30.6%) patients had no complications and the remainder had at least one of early or late complications. Overall, psychosocial complications, 56.4%; mucosal bleeding, 34.5%; early dermal irritation, 23.5% were the most frequent complications. Peristomal hernia (11.2%) was the most common late complication. Those aged > 40 years had significant associations with psychosocial problem (OR = 2.77), mucosal haemorrhage (OR = 2.19), and early dermal irritation (OR = 3.14). The risks of peristomal hernia and early dermal irritation are greater in the patients with BMI > 25 kg/m2 (OR = 2.08 and 2.55, respectively). CONCLUSION: The risk of most prevalent complications of colostomy construction increases in elder patients. The high prevalence of psychosocial and skin problems in patients with a colostomy, needs special attention especially from the viewpoint of education by trained stoma nurses and preparation of standard equipment.

Aged↗
PubMed1975

Results of psychosocial adjustment to long-term colostomy.

114 patients with permanent colostomy for carcinoma of the rectum were compared by questionnaire and interview with 110 cancer patients, having undergone colonic resection but not bearing a colostomy. The patients' own assessment of their health was for the colostomy group even better than for the controls. The emotional state before and after surgery showed significant degrees of hopelessness, depressions and fear especially for young women awaiting colostomy. Social contacts were considered as far as visits of friends or cinema, theatre are concerned. Sexual activity decreased significantly for 75% of colostomized men. In 40% organic lesions led to impotence. The Giessen test revealed significant rates of social impotence, negative social resonance and depression for men with colostoma.

Adaptation, Psychological↗
PubMed1995

Effects of cecal ligation and colostomy on motility of the rectum, ileum, and cecum in turkeys.

Motilities of the rectum, ileum, and ceca were examined in surgically prepared turkeys by using strain gauge transducers implanted on these sites after cecal ligation or colostomy. All birds were provided ad libitum access to feed and water throughout the study. Cecal ligation increased the frequency of small anti-peristaltic contractions in the proximal (P < .01) and distal (P < .05) rectum and the frequency of defecations (P < .05) compared with intact controls. Cecal ligation decreased the frequency of single contractions in the proximal ileum (P < .05) and that of all contractions in the distal ileum (P < .05), and ligation (P < .01) and colostomy (P < .05) increased the frequency of single contractions in the distal site. However, major and minor cecal contractions were not affected by colostomy in the proximal and distal cecum. The results suggest that the effects on contractile activities of the hindgut must be considered when interpreting responses to cecal ligation and colostomy.

Animals↗
PubMed1999

Limited utility of preoperative studies in preparation for colostomy closure.

Numerous diagnostic and therapeutic practices are used in an attempt to reduce the morbidity of colostomy closures. Our principal aim was to evaluate the role of preoperative studies, specifically barium enemas and endoscopic examinations, performed before colostomy closures. Additionally, we wished to identify other practices involved in the perioperative management of patients undergoing colostomy closure that influenced morbidity. The records of 100 consecutive patients who underwent elective colostomy closure at University of Louisville Hospital between January 1989 and July 1995 were reviewed. Wound infection was the most common complication (12%). Various bowel preparations were equivalent in efficacy and did not influence the complication rate. Intermittent wound irrigation with antibiotics for 3 days postoperatively, via subcutaneous drains, was associated with a low incidence of incision infection. Preoperative barium enema or sigmoidoscopy were often performed but rarely useful. Performing these examinations merely increased hospital cost without a corresponding decline in morbidity.

Adolescent↗
PubMed2001

[Protective colostomy or ileostomy?] ].

A group of patients is presented, where colorectal or coloanal anastomosis after resection was performed together with concomitant covering colostomy (102) or ileostomy (25), during the period 1985-2000. Covering colostomy was most often performed upon hepatic flexure (82.1%) and upon sigmoid colon (8.9%). The incidence of complications during performing or closure of colostomy was 6.8% with one case (0.8%) of death due to unsuccessful protection of primary anastomosis. The incidence of complications in covering ileostomy was 16%, with 3 (12%) deaths. Authors are analysing the data from literature about indications and technique of covering enterostomies, comparing them with their experience and concerning the choice of appropriate protective procedure. They came to conclusion that the reason for covering procedure has been in many instances reasonable, and that in the question of protection both methods are comparable, but covering ileostomy has potentially more dangerous complications. Therefore as a method of anastomotic protection authors are generally recommending covering colostomy except in technically specific cases.

Anastomosis, Surgical↗
PubMed2002

[Laparoscopic colostomy: experience in patients with ovarian or ano-rectal cancer, non-operable or with rectovaginal fistula].

Between August 1995 and May 2001 laparoscopic colostomy was successfully carried out in 23 patients with advanced ovarian cancer, inoperable carcinoma of the anorectum or rectovaginal fistulas. There were no intraoperative or postoperative complications and postoperative recovery was rapid with all patients having function of the colostomy within 24 hrs and regaining their preoperative state of mobility on the second postoperative day. The laparoscopic approach allows the careful selection of the colostomy site, easy mobilisation of the colon, causing only little disruption to the intestinal function hence improving postoperative recovery. From Authors' experience, laparoscopic colostomy is a simple and safe operation in most cases and can be used as the preferred technique of intestinal diversion.

Adult↗
PubMed2000

Radio-contrast imaging of the rectum prior to colostomy closure for rectal trauma--is routine use still justified?

This retrospective study was undertaken to assess the yield of radio-contrast imaging of the rectum before closure of colostomy following extraperitoneal rectal trauma. Sixty-nine patients (63 males) underwent colostomy closure in 36 months. All radio-contrast studies (colograms) performed before closure of colostomy were normal, and there were no deaths following closure. This study demonstrated that the yield from pre-closure radio-contrast imaging of the rectum after rectal trauma was negligible and did not influence colostomy closure. We conclude that while it may be appealing to suggest abandonment of its routine use, this investigation needs to be further evaluated prospectively with special attention given to injury to associated structures such as bone, bladder and vagina.

Adolescent↗
PubMedDate not supplied

[A simplified method of diverting colostomy].

The diversion of the fecal stream is necessary in some situations, to protect lower anastomosis, or in emergency operations on the colon. Several techniques of colostomy were described, in order to improve the sustaining bridge to the skin level, for the immediate placement of a colostomy bag. A simplified method of diverting colostomy is presented: a plastic tube bridge is passed subcutaneously, extraperitoneally, under the colon loop, permitting an immediate opening of the loop and the placement of the colostomy bag.

Anastomosis, Surgical↗
PubMedDate not supplied

Palliative management of malignant rectosigmoidal obstruction. Colostomy vs. endoscopic stenting. A randomized prospective trial.

BACKGROUND: Colostomy was the palliative treatment of choice in patients with malignant unresectable rectosigmoid obstruction. Palliative endoscopic treatment of malignant rectosigmoid obstruction by endoluminal self-expanding metallic stents is nowadays a well-established procedure. PATIENTS AND METHODS: Twenty-two patients, referred for treatment with diagnosis of malignant obstruction of the rectosigmoid region presenting an advanced unresectable stage, were enrolled. Patients were randomly assigned into two treatment groups (endoscopic stenting vs colostomy) according to random-number tables. The length of procedure, morbidity and mortality rate, canalization of the gastrointestinal tract, restoration of oral intake and hospital stay were assessed. RESULTS: Endoscopic group: The median length of procedure was 36 minutes. No death was observed. None of the patients reported complications. All patients resumed bowel function within 24 hours. The restoration of oral intake was achieved one day after stent placement. The median hospital stay was 2.6 days. Colostomy group: The median length of the operation was 75.4 minutes. No mortality was reported. In 1 patient (9.1%) stoma prolapse was observed 3 days after the operation. Canalization of the gastrointestinal tract was restored when colostomy was opened (on postoperative day 3). All patients were able to resume oral feedings on postoperative day 3. The median hospital stay was 8.1 days. CONCLUSION: There were no statistically significant differences between the 2 groups concerning morbidity and mortality. Endoscopic stenting was significantly more effective concerning operative time, restoration of bowel function and oral intake and median hospitalization. Our results would suggest that endoscopically placed metal stents offer an effective alternative to surgical palliation in patients suffering from unresectable malignant rectosigmoid obstruction.

Aged↗
PubMed2005

Creation of a permanent colostomy with the use of an intraluminal stapler device.

We present our experience with the use of the intraluminal stapler device for the purpose of creating of a permanent dermal colostomy in patients requiring acute emergency operations and for regularly scheduled procedures. The advantages of this method for surgeons who use stapling devices are controlled safety of the colostomy, reduced operation time, and the creation of a stable diameter of the colostomy. Furthermore, this method can be used in patients where a secondary operation is needed due to shrinkage or stricture of the primary colostomy during the first operation. This method has now been used in our clinic for five years with excellent results. All patients, including those having procedures related to colon cancer, are placed on a follow up protocol for three years and are closely monitored. This protocol has allowed us to closely follow these patients and any related complications such as stricture, stenosis, prolapse, in situ hernia, and ecstomosis.

Anastomosis, Surgical↗
PubMed1990

[Closure of the double-barreled colostomy].

In a survey of the literature the authors discuss the problem of double-barreled colostomy closure, which a remains controversial. The high percentage of postoperative complications--up to 50 per cent and mortality up to 2.1 per cent are responsible for nondetermination of the method of choice, depending on the type of colostomy, of the colostomy complications and the absence of indications for choice of the time of colostomy closure.

Colostomy↗
PubMed1990

[Colostomy devices for the extracorporeal organ].

Colostomy devices are classified as follows: One-piece and two-piece by structure; Closed, open-end or straight, open-top, drainable, and mini by pouch function. The one-piece device is simple and convenient (disposable) but not cheap; The two-piece one has various exchangeable pouches but some skill is necessary for fitting a pouch to the flange. A closed pouch is disposal en bloc, while an open pouch allows a hand to be inserted several times. The drainable pouch is useful for draining faeces easily with water, while a mini-pouch is unobtrusive and attractive. The skin barrier has been used frequently as a part of the device. Its contents are hydrophilic colloid, hydrophobic colloid and agglutinant. The barrier functioning is dependent on content-ratio and on structure. The latter is classified as blend, laminate, swiss-roll, polka-dot, and froth in type. The apparatus must be used for individual colostomy, utilizing the characteristics based on its specificity; an open-type one-piece unit is used with skin barrier for a postoperative colostomy in the first week, a drainable-type, two-piece unit for another week following suture removal or for diarrhea, and a closed type for rehabilitation. This procedure is called a pouch total system. The irrigation method is good for a scheduled defecation and for peri-stomal dermatitis and for a deformed stoma, but takes more than a half hour and needs a special toilet for irrigation. Indication of the method is for a young ostomate, a sportsman, a field worker, a neurotic or myosophobic person and so on. Today a pouch-free natural defecation method is becoming popular; a kind of stopper is used for a colostomy. This is a foam plug which expands to block feces and eliminates noise and odor. The method is good for pouch-free living, but fecal leakage is encountered in diarrhea.

Colostomy↗
PubMed1990

Percutaneous drainage of a diverticular abscess can make colostomy unnecessary in selected cases.

Diverticular abscess is a common acute abdominal problem in patients over 50 years of age and may require single or multiple operations. Percutaneous drainage of the abscess may permit a single operation in selected patients, making a colostomy unnecessary. This approach is probably underutilized and should become the procedure of choice in selected patients with no other medical problems such as immunosuppression. We report two patients, including one with a fecal fistula, in whom percutaneous drainage converted a situation in which two operations, one with a colostomy, would have been required, to a single operation without a colostomy. This approach saves about $7,000 per patient. The avoidance of colostomy and the cost savings make this approach attractive in selected patients with diverticular abscesses.

Abscess↗
PubMedDate not supplied

[Traumatic injuries of the colon: primary suture or colostomy?].

The indications for colostomies in traumatic lesions of the colon were prospectively analysed in the light of the anatomical and functional impairment, the time that elapsed after the injury and additional risk factors. In the period between January 1981 and June 1986 75 patients were operated for colonic trauma: 39 had gunshot wounds, 29 suffered stab wounds and seven had blunt injuries. Colostomies were indicated in 47 patients that presented the most severe lesions, whereas the other 28 patients underwent primary repair. Infectious complications occurred in 21 cases; they were related to a pre-operative interval of more than 10 hours, severity of colonic lesion (CIS) grade III to V, blood transfusion of more than 2500 ml, the presence of colostomy, and an abdominal trauma index (PATI) of more than 25. Five patients died in consequence of infectious complications (p less than 0.05), all of them suffering from severe injuries. These findings suggest that in acute trauma of the colon after less than 6 hours colostomy is justified when the CIS is III to V, the PATI more than 25, or in hemodinamically unstable patients.

Adolescent↗
PubMed1989

Technical aids in surgery. Completely defunctioning loop colostomy.

To avoid a double-barrel colostomy with its associated problems, a simple loop colostomy can be converted into a completely defunctioning colostomy by ligation of the distal limb with nylon. The technique ensures complete diversion of the faecal stream, and is simple, effective and reduces operating time. An added advantage is the ease with which it can be closed. It is believed that this offers a simple, but useful and important, alternative to the double-barrel colostomy at present in use.

Colostomy↗
PubMed1988

Left colon anastomotic healing following colostomy closure. An experimental study on rats.

The impact of colostomy closure on the healing of a left colonic anastomosis performed 4 weeks earlier was studied in rats. Colostomy closure could be safely accomplished but in 3 of 25 rats was followed by faecal obstruction due to narrowing of the primary left colonic anastomosis. After colostomy closure the gain in anastomotic strength was slow and did not exceed the outset value until after 3 weeks. After colostomy closure, accumulation of collagen in the anastomotic region increased earlier than anastomotic strength, indicating delay in collagen maturation.

Anastomosis, Surgical↗
PubMed1987

Colostomy or ileostomy after colorectal anastomosis?: a randomised trial.

Sixty one patients were entered in a randomised trial to compare transverse loop colostomy with loop ileostomy after a colorectal anastomosis thought to be at risk of dehiscence. Radiologically proven breakdown of the colorectal anastomosis occurred in 13% of these selected patients and most frequently in the colostomy group. Ileostomies functioned earlier than colostomies (P less than 0.001) but there was no other significant difference in outcome between the groups. In 52 patients intestinal continuity was restored by excision of the stoma within a month of construction with no difference in morbidity between the two groups. A loop ileostomy, closed as soon as the colorectal anastomosis has healed, is recommended as an alternative to transverse colostomy.

Aged↗