Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed1998

Appendicostomy irrigation for facilitating colonic evacuation in colostomy patients. Preliminary report.

A method for bowel irrigation through an appendicostomy (antegrade colonic enema) for patients with a left colostomy is described. The appendicostomy is easily constructed without morbidity. Irrigation through the appendicostomy is performed with minimum equipment, uses a small volume of irrigation water, and takes a relatively short time. This may improve colonic evacuation in patients with left colostomy.

Appendix↗
PubMed1998

Successful overlapping anal sphincter repair: relationship to patient age, neuropathy, and colostomy formation.

BACKGROUND: Fecal incontinence from single anal sphincter defects are surgically remedial and commonly the result of obstetric injuries. Overlapping anal sphincter repair has previously been associated in small series with good results in 69 to 97 percent of patients. OBJECTIVES: The aims of this study were to assess the results of overlapping anal sphincter repair in one institution and to assess the effects of age, presence of a neuropathy, and addition of a temporary colostomy on the success of surgery. METHODS: A study of 57 overlapping anal sphincter repairs in 56 (54 females) patients at the Royal Prince Alfred Hospital during a six-year period was performed. All patients were investigated preoperatively with endoanal ultrasound and concentric needle electromyography. Patients have been assessed prospectively since 1994 with a questionnaire, including a four-point Likert scale of continence level, the St. Mark's incontinence scoring system (range, 0-13), the Pescatori incontinence scoring system (range, 0-6), and patient assessment of success or failure of the overlapping anal sphincter repair. A colostomy was selectively formed in conjunction with an overlapping anal sphincter repair in 21 patients (8 preoperatively, 13 simultaneously), and 18 patients had a concomitant neuropathy (3 unilateral, 15 bilateral). RESULTS: After a median follow-up of 18 months, median continence scores overall had improved from St. Mark's incontinence scoring 13 to 3 (P < 0.0001) and Pescatori incontinence scoring 6 to 2 (P < 0.0001). Forty-nine of 57 (86 percent) repairs have been successful, and 8 are considered to be failures. Twenty-one of 27 (78 percent) repairs in patients younger than 40 years of age were successful, as were 28 of 30 (93 percent) repairs in patients older than 40 years of age (P = 0.10). Four of 18 (22 percent) repairs associated with a neuropathy failed compared with 4 of 39 (10 percent) without a neuropathy (P = 0.21). Improved or normal continence was achieved in 17 of 21 (81 percent) patients with a stoma and overlapping anal sphincter repair and in 32 of 36 (89 percent) patients with an overlapping anal sphincter repair alone (P = 0.32). The presence of a stoma did not improve the rate of wound healing by primary intention (62 percent for stoma vs. 64 percent for overlapping anal sphincter repair alone; P = 0.55). CONCLUSIONS: Single anal sphincter defects can be successfully treated with an overlapping anal sphincter repair. There is no improvement in primary healing with selective stoma formation. Age of the patient and presence of a neuropathy should not detract from proceeding with overlapping anal sphincter repair when singular anal sphincter defects are detected on endoanal ultrasound in muscle that is still active.

Adolescent↗
PubMed1999

Quality of life after surgery for rectal cancer: do we still need a permanent colostomy?

INTRODUCTION: A permanent colostomy is a serious limitation of the quality of life. Besides cure of cancer, preservation of sphincter function is an important goal of surgery for rectal cancer. METHODS: In a prospective study a concept offering every patient with rectal cancer either sphincter salvage or a "neosphincter" was investigated, and the impact of this strategy on oncologic results, sphincter function, and quality of life was analyzed. RESULTS: From 1992 to 1997, 276 patients were accepted for the study. Two hundred sixty-one patients had elective surgery, and 15 patients had emergency surgery for their rectal tumors. The postoperative mortality rate was 4 percent. A radical resection (R0) was possible in 197 patients (75 percent). Anterior resection was the most common procedure (n = 87), and intersphincteric resection with coloanal anastomosis was the preferred method for low tumors (n = 65). Abdominoperineal resection was necessary in 15 cases. Thirteen patients had an immediate restoration of sphincter function by means of a dynamic graciloplasty, and 2 patients needed emergency abdominoperineal resection for bleeding. The follow-up was relatively short (median, 36.4 months) at the time of data analysis and showed a local recurrence rate of 8 percent. Although postoperative continence according to the Williams score revealed satisfactory results, subjective quality of life and the scale for specific symptoms showed a significantly worse outcome in patients with ultralow (coloanal) anastomoses compared with those with anterior resection. CONCLUSIONS: We conclude that for elective curative surgery of rectal cancer, a permanent colostomy is not necessary provided all presently available techniques of sphincter salvage and restoration are applied. However, the patient has to be informed about possible side effects associated with surgical procedures such as coloanal anastomosis or neosphincter reconstruction, to avoid severe psychological difficulties.

Aged↗
PubMedDate not supplied

Blunt pelviperineal injuries. An expanded role for the diverting colostomy.

The combination of blunt pelvic and perineal injuries is relatively uncommon but carries with it a high morbidity and mortality. A colostomy with distal wash-out plays a significant role in the prophylaxis of septic complications, even in the absence of recognizable colorectal trauma. Among 14 patients with this type of injury, there were six deaths (42 per cent). Three patients died initially because of hemorrhage, and three late deaths were due to sepsis. Two of these patients had no colostomy, and one had a diversion without wash-out. The indications for proximal diversion should be broadened to include an expanded view of the perineum, herein presented.

Colostomy↗
PubMed1985

Temporary colostomy--an outmoded procedure? A report on the intracolonic bypass.

The intracolonic bypass is a procedure preventing the gastrointestinal secretions and fecal contents from coming into contact with an anastomotic closure site without interrupting the intraluminal continuity of fecal flow from proximal to distal colon. Experimental and clinical data have indicated that the intracolonic bypass can protect such an anastomosis, in the presence of maximal colonic loadings, dehiscences, and fecal peritonitis. This single stage procedure obviates the necessity for construction and subsequent closure of a temporary colostomy in situations where it is currently indicated; the morbidity, mortality, psychologic problems, and economic costs associated with these multiple procedures are avoided. Sufficient experience now has been gained to recommend the intracolonic bypass as a viable alternate to temporary colostomy.

Adult↗
PubMed1987

Analysis of the morbidity, mortality, and cost of colostomy closure in traumatic compared with nontraumatic colorectal diseases.

One hundred sixteen patients with acute colorectal diseases, operated upon emergently and needing an intestinal stoma, were reviewed to determine the cost and morbidity of treatment of patients with colorectal trauma compared to other surgical illnesses. The first group (57 patients) perforating colonic or rectal trauma, the second (30 patients) perforated colonic disease, the third (24 patients) nonperforated colonic disease, and the fourth (five patients) a colonic injury, unrecognized initially but requiring subsequent treatment with a stoma. For the initial operation, hospital stay, complications, mortality, and costs were less for patients in group 1 (colonic injury) than in groups 2 and 3 (inflammatory or neoplastic diseases). Colostomy closure, whatever the antecedent disease or injury, required an average ten-day hospitalization, had no mortality, a complication rate of 0 to 6 percent, and an average hospital cost of $6,500. The hospital stay and costs for the total treatment were slightly higher for nontraumatic illnesses, although the rate of colostomy closure was significantly less (68 and 77 percent versus 86 percent, P = .05).

Adult↗
PubMed1988

Perineal continent colostomy. Report of a case.

A case of abdominoperineal amputation with continent colostomy with neosphincter implanted in the perineum is presented. The technique and its follow-up of 19 months are related. The success of 24-hour continence and the patient's comfort when compared with that of classic abdominal colostomies justify its use in selected patients.

Anus Neoplasms↗
PubMed1985

Construction and closure of the transverse loop colostomy.

The clinical courses of 211 patients having transverse loop colostomies performed during the years 1969 to 1980 in the Stockholm region were examined to evaluate problems connected with construction and closure. Forty-seven percent of these stomas became permanent. The morbidity rate for colostomy construction and closure seemed to be independent of the operative techniques used, the underlying disease, and the timing of closure. Thus, early closure (within six to eight weeks after construction) did not affect the local complication rate from the stoma. A meticulous surgical technique is of great importance, and stoma construction and closure is therefore not to be considered a minor operative procedure.

Adult↗
PubMedDate not supplied

Closure of colostomy--a safe procedure?

A retrospective surgery of a series of 73 patients undergoing closure of colostomy has been carried out. Closure was complicated in 37.8 per cent of cases, and fecal fistulas occurred in 17.6 per cent. The overall mortality rate of the procedure was 2.7 per cent. The underlying disease (carcinoma or diverticulitis) did not influence the complication rate. Furthermore, intraperitoneal and ex-raperitoneal methods of closure appeared equally satisfactory. Closure of colostomy within a month of construction was associated with an unacceptably high incidence of fecal fistula of 33 per cent.

Adult↗
PubMedDate not supplied

Treatment of paracolostomy abscesses without proximal diverting colostomy: report of two cases.

Two patients had paracolostomy abscesses limited to the abdominal wall. Adequate drainage was obtained surgically using local anesthesia, but wound contamination from the fecal stream continued. Intravenous hyperalimentation and/or elemental diet reduced fecal volume, promoted wound healing and weight gain, and prevented the need for a proximal defunctionalizing colostomy. During follow-up periods of more than ten months, colostomy revision has not been necessary.

Abscess↗
PubMedDate not supplied

A comparison of the results of extraperitoneal and intraperitoneal techniques for construction of terminal iliac colostomies.

In a series of 251 patients followed for at least two years after abdominoperineal excision for carcinoma of the rectum, those given extraperitoneal iliac colostomies were found to have significantly lower incidences of pericolostomy herniation, prolapse, and recession than those given intraperitoneal colostomies. There was no difference between the frequencies of mechanical intestinal obstruction.

Colon↗
PubMed1980

Morbidity and mortality following intraperitoneal closure of transverse loop colostomy.

A retrospective analysis of 153 patients having intraperitoneal closure of transverse loop colostomies was performed. The mortality was 1.4 per cent. The morbidity rate was 15 per cent, including 7 per cent wound infection was not significantly improved by the use of systemic or nonabsorbable intestinal antibiotics. Intraperitoneal drainage resulted in the highest rate of wound infection. However, the use of intraperitoneal drains seems justified for the control of fecal fistula if it should occur. The lowest incidence of complication was noted when colostomies were closed in 2--4 months. Particular attention must be given to cases with diverticulitis as these have a greater morbidity. Factors which reduce morbidity appear to be directly related to clean and careful dissection of the bowel with a sound technique of anastomosis.

Adult↗
PubMed2001

Gasless laparoscopic-assisted ileostomy or colostomy closure using an abdominal wall-lifting device.

BACKGROUND: Restoration of intestinal continuity in patients with ileostomy after total colectomy or with colostomy after Hartmann's procedure is a major operation. Herein we illustrate the validity of gasless laparoscopically assisted reversal using abdominal wall lifting. METHODS: The operation was performed on 10 patients from February 1997 to May 1999. Seven of them had a left iliac stoma after a Hartmann resection, and three had an ileostomy after total colectomy. RESULTS: The laparoscopic reversal was completed in eight patients; the two others were converted to an open procedure. Three major complications occurred (30%). There were no deaths. The average operation time was 192 min (range, 125-265). Time of discharge from surgery averaged 9.5 days. Mean follow-up of these patients was 12 months and negative. CONCLUSIONS: Laparoscopically assisted ileo- or colorectal anastomosis without pneumoperitoneum and using a laparotenser can be considered for the reversal of patients with ileostomy or colostomy. Even taking the high rate of intraoperative or postoperative complications into consideration, the advantages that make such a laparoscopic approach suitable include reduced trauma related to a second major abdominal operation, reduced postoperative pain, and fewer cutaneous tissues exposed to bacterial contamination. Moreover, the use of a laparotenser makes it possible to operate on elderly patients with cardiovascular diseases. In the absence of pneumoperitoneum, it becomes possible to use traditional instruments, with a consequent reduction in costs.

Abdominal Muscles↗
PubMed2002

Metachronous adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma.

Carcinomas rarely occur at the site of a colostomy. A 73-year-old man underwent abdominoperineal resection (Miles' surgical procedure) for rectal carcinoma in September 1988. He did not return to the hospital until September 1995, when he was admitted with stricture of the stoma. Neither tumor nor ulcer was detected at the stoma. The tip of the doctor's little finger was able to pass through the stoma, and manual expanding alleviated the stricture. The patient did not return to the hospital again until August 1996, at age 81 years, when he visited the hospital because of complete stricture of the stoma. A biopsy revealed an adenomatous carcinoma, but the results of various examinations suggested no metastasis. A portion of the intestine, including the stoma and surrounding skin, was resected, and a new stoma was created in the descending colon. We report this rare carcinoma occurring at the site of a colostomy, and we review the literature.

Adenocarcinoma↗
PubMed2004

Local correction of a transverse loop colostomy prolapse by means of a stapler device.

Prolapse is a common complication in patients with a transverse loop colostomy. In most cases, the prolapse can be managed conservatively awaiting time for closure eventually. However, loop stoma may also be intentionally permanent or the patient may be too fragile to have the colostomy closed and in these cases a laparotomy is required for correction of the prolapse. A simple method allowing local correction of the prolapsed loop stoma is described.

Colectomy↗
PubMed2006

A study comparing split with loop transverse colostomies for defunctioning the left colon.

BACKGROUND: Loop transverse colostomy (LTC) is an established method for defunctioning the distal colon. We recently described an alternative method called split transverse colostomy (STC). METHODS: In this study we retrospectively compared the outcomes of LTC and STC in 49 patients with colorectal malignancy, pelvic tumours and diverticular disease. RESULTS: Patients were assigned without randomisation to undergo LTC (n=25) or STC (n=24). The two groups were similar in terms of age, gender and diagnosis. Postoperative complications were observed in 52.0% of patients in LTC group and in 16.7% of patients in STC group (p<0.05). The most common complication in both groups was stomal prolapse (n=2 and n=10, respectively). There were no intra-operative deaths. CONCLUSIONS: STC is safe, effective and associated with a lower incidence of stomal complications compared with the established procedure for defunctioning the distal colon. We propose that STC should be used to defunction the left colon in locally advanced disease (whether benign or malignant) where closure of the stoma is not envisaged.

Aged↗
PubMed2006

The skin bridge loop colostomy.

Loop colostomy formation commonly involves temporary support over a plastic bridge. We describe a technique of loop colostomy using a permanent skin bridge. By joining two inter-digitating skin flaps raised from the margins of the stoma, an adjustable bridge is formed that can accommodate colon loops of any diameter. In a series of twenty cases, our technique has been complication free and well tolerated by patients.

Colostomy↗
PubMed2003

Turnbull-Blowhole colostomy for toxic ulcerative colitis in pregnancy: report of two cases.

PURPOSE: Surgical intervention for toxic ulcerative colitis in pregnancy is associated with a high morbidity and mortality for both mother and her fetus. A limited surgical procedure may be desirable to reduce the risk of maternal and fetal mortality. We describe the use of "blowhole" colostomy and loop ileostomy (Turnbull procedure) in the management of toxic dilation of the colon complicating ulcerative colitis in pregnancy. METHODS: The medical records of two pregnant females with toxic ulcerative colitis were reviewed. The presentations, management, and outcomes of these patients and their neonates are described. RESULTS: The Turnbull-Blowhole colostomy and ileostomy was used in the acute management of toxic ulcerative colitis in two pregnant females. Both mothers and neonates had successful outcomes with resolution of the acute process. Completion proctocolectomy and ileal pouch-anal anastomosis was later performed in both patients. CONCLUSIONS: The colonic decompression and fecal diversion procedure provided minimal operative trauma to the mother and fetus and resulted in successful outcome in the management of toxic ulcerative colitis in pregnancy. We believe the procedure is safe, effective, and relatively simple, which may reduce the morbidity and mortality of toxic colitis in pregnancy.

Adult↗