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PubMed2001

Effects of caecal ligation and colostomy on water intake and excretion in chickens.

1. The effect of caecal ligation and colostomy on water intake and excretion were examined in chickens fed a low-protein diet or a low-protein diet supplemented with urea. 2. When fed a low-protein diet, the water intake and the ratio of water intake to food intake were increased by colostomy (P < 0.05) but not changed further by caecal ligation of colostomised chickens. 3. When fed a low-protein diet supplemented with urea, the amount of water intake and the ratio of water intake to food intake were not changed by either treatment. 4. Total water excretion was much higher in the colostomised plus caeca-ligated chickens than in other 3 groups fed both types of diet (P < 0.05). 5. The amount of faecal water excretion was increased by cecal ligation in colostomised chickens fed either diet (P < 0.01). 6. No effect of any treatment on water balance was observed in chickens fed either diet. 7. It is concluded that the lower intestine plays a useful role in the water economy of chickens fed a low-protein diet or a low-protein diet supplemented with urea.

Animal Feed↗

PubMed1983

Modification of pancreatic carcinogenesis in the hamster model. 5. Effect of partial pancreatico-colostomy.

Studies were conducted to evaluate the possibility of a bile reflux mechanism in the etiology of induced pancreatic cancer. N-Nitrosobis(2-oxopropyl)amine (BOP) was administered to Syrian hamsters after partial pancreatico-colostomy. Either the gastric or the splenic lobe of the pancreas was anastomosed to the transverse colon in groups 1 and 2, respectively. Group 3 were sham-operated controls and group 4 were controls without surgery. Shortly after surgery all 4 groups received a single subcutaneous BOP injection (20 mg/kg body weight) and survivors were sacrificed 46 weeks after BOP treatment. BOP-induced pancreatic tumor patterns were not altered by pancreatico-colostomy when compared with those in sham-operated controls. In all BOP-treated hamsters the number and distribution of benign and malignant lesions were similar in each individual pancreatic segment, including the anastomosed lobe (A-lobe); some hamsters developed tumors only in the A-lobe. As in other pancreatic regions, the initial hyperplasia in the A-lobe primarily affected peri- and intra-insular ductules and less frequently involved the ducts. These findings support the theory that the carcinogen is bloodborne and indicate that BOP-responsive pancreatic cells are distributed on a volume basis in distinct proportions within the pancreatic segments. As in previous experiments a higher incidence of pancreatic neoplasms was found in BOP-treated controls (those not operated upon) than in partially pancreatico-colostomized hamsters, including those with sham operations. Hyperplastic and dyplastic development of colonic mucosa around the anastomosis could be related to a local effect of carcinogen or of its metabolites, which are known to be excreted via pancreatic secretions.

Animals↗

PubMed1996

Colostomy in penetrating colon injury: is it necessary?

OBJECTIVE: To compare in a randomized prospective manner the complication rates associated with colostomy versus primary repair in penetrating colon injuries. METHODS: During a 38-month period, 114 patients with penetrating wounds of the colon were entered into a randomized prospective study at an urban Level I trauma center. The patients were randomized to a primary repair group or a diversion group. Randomization was completely independent of any risk factors, including number of abdominal organ systems injured, extent of fecal contamination, blood loss, presence of shock (systolic blood pressure < 80), time from injury to operation, and severity of colon injury. Five patients initially entered in the study died in the immediate postoperative period (< 24 hours) and were removed from the study because their deaths were unrelated to their colon injuries. RESULTS: A total of 109 patients were studied, of which 56 were randomized to primary repair and 53 to diversion (39 colostomies, 14 ileostomies). The average age for the primary repair group was 28.5 years and for the diversion group it was 26.8 years. The average Penetrating Abdominal Trauma Index for the primary repair group was 24.3 and for the diversion group it was 22.8. There were 11 (20%) septic-related complications in the primary group versus 13 (25%) in the diversion group. Complication rates in the presence of significant fecal contamination, shock, significant blood loss (> 1000 mL), more than two organ systems injured and extent of colon injury were all higher in the diversion group. There was one mortality in the diversion group and two in the primary repair group. CONCLUSIONS: The authors conclude that all penetrating colon injuries in the civilian population should be primarily repaired.

Adult↗

PubMed1980

Low complication rate of colostomy closures.

Colostomy closure, a procedure often relegated to the less experienced member of the surgical team, is not a benign procedure. Early reports in the literature have clearly indicated that colostomy closure is attended by an exorbitantly high complication rate. The complication rate of 12% at the Medical Center of Central Georgia from 1972 to 1977 was very much lower than those reported in the literature in the past decade. We believe this relatively low rate of complication is basically due to: (1) proper mechanical and chemical preparation of the colon preoperatively, (2) delayed primary closure of wounds, and (3) meticulous attention to detail in surgical technic.

Adolescent↗

PubMed2004

Changes in nitrergic innervation of defunctionalized rat colon after diversion colostomy.

After 45 days of complete diversion colostomy in male Wistar rats, morphometry of soma and nuclei of NADPH diaphorase positive cells of the myenteric plexus was evaluated. There was a significant (P < 0.0001) diminution in the area, perimeter and volume-weighted mean volume of soma and nuclei of nitrergic myenteric neurones in the defunctionalized colon. In addition, there was a significant reduction in the neuronal density of the myenteric neurones, and increased distance between the ganglia. In addition, there was myenteric glial atrophy. Atrophy of colonic myenteric neurones was accompanied by significant reduction (P < 0.001) in the volume fraction of the muscularis externa, the prime targets of these neurones. The disturbances in the microecology of the colon may jeopardize the finely orchestrated functioning of the components of the Enteric nervous system (ENS) leading to colonic dysfunction. Our observations, by extrapolation, may explain the bowel dysmotility in humans after restoration of colonic continuity after colostomy.

Animals↗

PubMed1976

Closure of colostomy.

A retrospective review of 110 patients who had their colostomies closed during the period from 1963 to 1973 has been undertaken. Their average age was 64 years. Diverticular disease and colorectal cancer had been the most frequent indications for the colostomy. Wound infection occurred in 36.4% and faecal fistula in 7.3%. These complications occurred less frequently in patients who had antibiotic bowel preparation. The overall mortality rate was 4.5%. Measures to reduce the morbidity and mortality are discussed.

Adult↗

PubMed1989

Colostomy closure.

One hundred and forty-seven colostomies were closed in 146 patients at Wellington Hospital between 1 January 1978 and 1 January 1987. The majority of stomata were formed in patients with colorectal cancer. At least one additional significant procedure was undertaken at the time of stoma closure in 10 patients. The overall complication rate was highest in those patients undergoing closure of a sigmoid end-colostomy (50%). Three complications resulted in death (2%). Twenty-four patients (16.3%) developed wound infections. Five patients developed 'leaks' (3.4%). The use of prophylactic antibiotics appeared to reduce the rate of infection significantly. The highest rates of wound infection and leakage occurred in patients in whom drains were used. Wound infections increased hospital stay. Thirty-one non-bowel or wound-related complications occurred in 25 patients.

Colostomy↗

PubMed1986

Colostomy control device.

Temporary or permanent colostomy produces many difficulties such as continuous fecal flow, odor, skin irritation, rash, edema, and uncleanliness. Efforts to resolve these difficulties have not had much success. The present work describes the development of a new colostomy control device and its successful application to eight patients. The device is removable and allows the patients to empty their bowels naturally. Following the bowel movement and cleaning of the stoma, the device is reapplied. The patient remains continent and experiences a psychological uplift from being able to feel the urge for bowel movements. The application of the device is easy and leads to no complications.

Adult↗

PubMed2003

Use of an incontinent end-on colostomy in a dog with annular rectal adenocarcinoma.

An 11-year-old, mixed-breed dog with dyschezia, tenesmus and haematochezia was presented. A rectal stricture caused by an adenocarcinoma was diagnosed. Following the failure of a rectal 'pull-through' procedure, which dehisced seven days later, an incontinent end-on colostomy was performed, allowing amputation of the colorectum with the anus and perineal skin. A two-piece device consisting of a flange and a drainable pouch was used for postoperative faecal evacuation and collection. Mild peristomal dermatitis was the only complication. Patient management was easily carried out by the owner at home, and the dog survived for four months with a satisfactory quality of life. Incontinent end-on colostomy may prove to be a useful treatment for canine annular colorectal tumours.

Adenocarcinoma↗

PubMed1972

Results of closure of loop transverse colostomies.

The postoperative course of 139 patients who underwent closure of a loop transverse colostomy at St. Mark's Hospital between 1961 and 1970 after distal resection and anastomosis of the large intestine for neoplastic or diverticular disease has been reviewed in detail. There were no deaths and the incidence of breakdown at the site of the colostomy closure was 2.9%. The procedure can be straightforward and safe.

Adult↗

PubMed1985

An unusual complication of stenosis of a colostomy.

A patient is reported in whom stenosis of the colostomy was responsible for perforation of the colostomy by a bone. Necrotizing gangrene of the abdominal wall developed. The management of the resulting full thickness defect of the abdominal wall is described.

Aged↗

PubMed1991

Stercoral perforation of the colon proximal to an end colostomy.

Stercoral perforation of the colon is rare, and has not previously been reported as a postoperative complication, proximal to an end colostomy. Two such cases are reported; in addition in one the stercoral perforation was recurrent, emphasizing the multifocal nature of the disease. Both cases demonstrate the failure of standard techniques to deal with scybala in the loaded proximal colon. It is, therefore, suggested that intra-operative orthograde colonic lavage is indicated to protect a terminal colostomy from the risk of stercoral perforation in such cases.

Adult↗

PubMed2003

Colonoscopy-assisted 'trephine' sigmoid colostomy.

Fecal diversion is often required to treat complex traumatic, malignant or inflammatory anorectal conditions. In such circumstances, the formation of a proximal, 'trephine' sigmoid colostomy would avoid the need for, and the associated morbidity of, a formal laparotomy. We describe a technique which combines intraoperative colonoscopy with a diverting, 'trephine' sigmoid colostomy, thereby helping the surgeon to identify the correct loop of bowel, to avoid inadvertent maturing of the wrong end of the divided colon, and to exclude intracolonic lesions.

Anastomosis, Surgical↗

PubMed1984

Psychic factors determining the long-term adaptation of colostomy and ileostomy patients.

The long-term psychosocial adaptation of 34 colostomy patients, operated on for rectal or colonic cancer, and 32 ileostomy patients, operated on for colitis ulcerosa, was examined on average 6.5 years after the operation. The methods used were Heidelberg Colostomy Questionnaire, Beck's Depression Inventory, Block's Ego Resiliency Scale and the Rorschach Inkblot Test. The results showed that the first pre- and postoperative psychic reactions were particularly strong and similar in both groups but the later adaptation was in every respect better in the ileostomy group. The necessity of guidance and psychic support was obvious.

Adaptation, Psychological↗

PubMed2005

Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy.

BACKGROUND: Quality of life of stoma patients is increasingly being addressed in clinical trials. However, the instruments used in the majority of these studies have not been validated specifically for stoma patients. The aim of this paper is to describe the development and validation of a quality-of-life instrument, "Stoma-QOL", specifically for patients with colostomy or ileostomy. METHODS: Potential items were formulated in English on the basis of the results of a series of semi-structured interviews with 169 adult stoma patients. The process resulted in a preliminary 37-item version, which was translated into French, German, Spanish and Danish, and administered repeatedly to 182 patients with colostomy or ileostomy. A psychometric selection of items was performed through Rasch Analysis. The measurement properties of the final questionnaire version were subsequently tested. RESULTS: The 20 items in the final questionnaire covered four domains--sleep, sexual activity, relations to family and close friends, and social relations to other than family and close friends. These items were found to define a unidimensional variable according to Rasch specifications (Infit MNSQ < 1.3). Internal consistency reliability calculated as Cronbach's alpha was 0.92, i.e., highly reliable. Spearman's correlation coefficients of scores across times of administration was > 0.88 (p < 0.01), indicating a high test-retest reliability. Item calibrations by country calculated as ICC were 0.81 (0.67-0.91 95% CI), confirming cross-cultural comparability across the European countries included in the study. CONCLUSION: Given the adequacy of the metric properties of the Stoma-QOL suggested by the psychometric analyses, this study confirms the suitability of the instrument in clinical practice and in clinical research.

Adaptation, Psychological↗

PubMedDate not supplied

Changes in diet following the formation of a colostomy.

The main aim of this small study was to discover if the formation of a colostomy could adversely affect the long-term dietary intake of patients. While it would seem that there were few adverse effects on nutrient intake after surgery, it became apparent that patients had a need for clear dietary advice. It seemed that this area of their care was lacking. Because of the small number of patients recruited for the study statistical validation was not possible. Therefore, this study is only able to point the way forward for further research into the dietary needs of colostomy patients and the health professional role in this area of care.

Aftercare↗

PubMed1994

Growth hormone treatment of rats with chronic diverting colostomy. Differential response on proximal functioning and distal atrophic colon.

Diversion of colon from the fecal stream leads to profound intestinal atrophy. After diverting colostomy for 4 weeks, female rats were treated with biosynthetic human growth hormone (b-hGH; 2.0 mg.kg-1 body wt.day-1) in order to investigate whether b-hGH could reverse atrophic changes in distal colon, with special reference to changes in morphometric composition, collagen content and biomechanical properties. Biosynthetic hGH treatment for 28 days stimulated growth of the muscularis propria of the defunctioned, atrophic colon (p < 0.05), whereas the mucosal atrophy was unaffected by the treatment. In colon proximal to the colostomy, however, b-hGH increased the colonic wet weight (p < 0.01), defatted dry weight (p < 0.005) and the collagen content (p < 0.05). Morphometric analysis showed that the growth increase was localized to the mucosa and the muscularis propria. In conclusion, fecal diversion alters the response of b-hGH treatment and indicates that the trophic effect of growth hormone on colonic mucosa is dependent on fecal bulk passage, whereas the trophic effect on muscularis propria is fully retained when colon is deprived of luminal nutrients.

Animals↗

PubMed1992

[The feelings and suggestions expressed by colostomy patients who self-irrigate].

The analysis of feelings and suggestions presented by a group of colostomy patients which use a specific method of colostomy self-irrigation showed that it's well accepted by these patients. After the positive results using this method, we obtained 88.14% of the positive feelings answers specially wellbeing, safety and normality and an average of 0.35 suggestions per client.

Colostomy↗