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PubMedDate not supplied

Use of total parenteral nutrition as a "medical colostomy" in management of severe lacerations of the sphincter: report of a case.

A case of anal-sphincter injury with total fecal incontinence is presented. The use of total parenteral nutrition (TPN) as a "medical colostomy" is stressed. After four weeks of support by TPN, the perineal wound had healed and successful sphincteroplasty was performed. TPN was used in the postoperative period to delay bowel movements for one week. The general concept of the use of TPN in sphincter injury is presented giving the surgeon an option in management of these injuries without resorting to a preliminary colostomy.

Adult↗
PubMed1955

Colostomy care.

Psychic preparation of the patient for the necessity of colostomy is a long first step toward his adjustment to living with an artificial anus. Proper surgical placement of the outlet will ease care of the bowel. Control of fecal consistency and peristaltic rate should ideally produce constipation responsive only to habit or enemata. The object of the enema is to produce an evacuation thorough enough to prevent soiling for a day or two. The object of dietary variations is to produce a manageable volume and consistency of fecal stream. The technique of enemas and choice of diet can be individualized when the underlying principles are understood.

Colostomy↗
PubMed2001

Temporary transverse colostomy vs loop ileostomy in diversion: a case-matched study.

HYPOTHESIS: For temporary fecal diversion, transverse colostomy (TC) has superior safety, but loop ileostomy (LI) has superior management qualities. METHODS: Of patients with TC or LI seen between 1988 and 1997, 63 patients were matched for diagnosis, operative procedure, and date of surgery. The 2 groups were then compared for hospital/postoperative mortality and morbidity and stoma complications. RESULTS: Mortality rates were 6.3% for the TC group and 1.6% for the LI group (P =.25). Morbidity rates for stoma creation and for stoma closure were 47.6% and 10% (P =.19), respectively, for the TC group, and 36.5% and 6.3% (P>.99), respectively, for the LI group. Most morbidity events were minor, and neither procedure-related nor other medical complications showed a significant difference between the groups. However, patients with a TC were significantly more likely to experience skin trouble around the stoma (TC vs LI, 15.9% vs 3.2%) and leakage around the stoma (TC vs LI, 12.7% vs 1.6%). CONCLUSIONS: Regarding safety, TC and LI should be considered equivalent options for temporary fecal diversion. We recommend further study comparing the 2 procedures with regard to patient perception and quality of life.

Adult↗
PubMed1976

Is colostomy closure a hazardous procedure? A comparison of elemental diet and routine bowel preparation.

Morbidity after closure of a colostomy is low if a simple antiseptic technique of intraperitoneal closure is used. In 26 patients there was no example of major wound sepsis and only 2 faecal fistulas both of which rapidly closed spontaneously. A randomized study of preoperative bowel preparation incorporating an elemental diet showed no apparent advantage for this method using our criteria for assessment.

Colostomy↗
PubMed1977

The Erlangen magnetic colostomy control device: technique of use and results in 22 patients.

The evolution and general principle of the Erlangen magnetic ring colostomy device are described and its practical use illustrated by reference to a personal series of 22 patients treated with the device. Analysis of the functional results obtained in 13 of these cases, who were assessed after at least 3 months' trial, shows that only 3, or at most 4, could be considered to have achieved worth-while continence, but there are grounds for believing that these results might be improved a little by more stringent selection of patients for the procedure and by employing a more meticulous technique for implanting the rings.

Colostomy↗
PubMed1977

Closure of a loop colostomy by a modified Le Gac's operation.

The results of closure of a loop colostomy presented by various authors are reviewed. It is suggested that postoperative faecal fistula is due most frequently to oedema and constriction at the site of bowel closure. Le Gac's method of closure is described. It comprises excision of the stoma and spur with side-to-side as well as end-to-end anastomosis, and it results in a wide lumen closure. A modified Le Gac's operation is described in which the mesocolic spur is not removed.

Colon↗
PubMed1979

Closure of colostomy in infants and children.

A retrospective survey of 100 consecutive colostomy closures in infants and children is presented: the operative technique consisted of bowel resection and anastomosis, usually as a single layer, with intraperitoneal closure. Faecal fistula occurred in 5 cases and there were other major complications in 8 instances. Wound infection occurred in 43 patients. The subsequent use of a more aggressive bowel preparation reduced the incidence of this complication.

Child↗
PubMed1980

Towards fewer colostomies--the impact of circular stapling devices on the surgery of rectal cancer in a district hospital.

Circular stapling devices can be used to extend the range of anterior resection of the rectum to encompass most of anterior resection of the rectum to encompass most rectal carcinomas. In one district general hospital the number of abdominoperineal resections performed in a 12-month period has been reduced from 27 to 4. A personal series is presented of 40 patients in whom the new technique allowed restorative resection to replace permanent colostomy. Special care is essential in the preparation of the colon for the low anastomosis.

Adult↗
PubMed1984

Colostomy irrigation with prostaglandin E2 and bisacodyl. A double-blind cross-over study.

The emptying of the colon and the side-effects after intraluminal application of prostaglandin E2 and of bisacodyl in 14 patients was studied by employing colostomy irrigation. The design was double-blind with cross-over, the irrigation was one litre of tap water to which was added in randomized sequence placebo, prostaglandin *2 (350, 700 and 1400 micrograms) or bisacodyl (1.25, 2.5 and 5 mg). Neither prostaglandin E2 nor bisacodyl had any significant effect.

Adult↗
PubMed1984

Obstructing/perforated carcinoma of the left colon treated by resection and the formation of a double colostomy.

Forty patients presenting with obstructing left colon tumours between 1975 and 1980 were treated by a modified Paul-Mikulicz resection. The hospital mortality was 5 per cent. Subsequent mortality was largely related to the stage of the tumour at presentation and was not higher than that to be expected after an elective resection. In 21 patients the procedure was palliative and 16 of these patients later died. The quality of palliation was reasonable in 80 per cent and poor in 20 per cent. Despite the need for a second hospital stay to close the colostomy, time in hospital accounted, on average, for less than one-tenth of the remaining lifespan in those having a palliative resection.

Aged↗
PubMed1995

Experience with ileostomy and colostomy in Crohn's disease.

This study involved 746 patients with Crohn's disease treated surgically within a 13-year interval in whom 227 stomas (159 primary, 68 secondary) were created. The main indication (64 per cent) for primary stoma was severe perianal or genital fistulous disease. Revisional surgery for stomal complications was more common following colostomy than ileostomy (31 versus 5 per cent, P < 0.01). Twenty years after the first symptoms of Crohn's disease the cumulative risks of receiving any stoma or a permanent stoma were 41 and 14 per cent respectively. Four parameters were shown by proportional hazards analysis to be independently associated with the risk for any stoma as well as a permanent one; increased risk coincided with rectal inflammation, perianal fistula or abscess, and absence of small intestinal involvement. In addition, long-standing symptomatic disease before the first surgical intervention reduced the risk of a permanent stoma. The long-term chances of closure following temporary stoma were 75 per cent when used for anastomotic protection or avoidance, 79 per cent after postoperative complications, and 40 per cent for perianal or genital fistulas or for rectal inflammation or stenosis. Rectal disease and perianal fistula were the only independent predictors of a low possibility of stoma closure during follow-up.

Abdominal Abscess↗
PubMed2006

Double-barreled wet colostomy is a safe option for simultaneous urinary and fecal diversion. Analysis of 56 procedures from a single institution.

BACKGROUND AND OBJECTIVES: Wide pelvic tumors need urinary and fecal diversion. We set out to assess the efficacy of the double-barreled wet colostomy (DBWC) in patients undergoing simultaneous double diversion. MATERIAL AND METHODS: We reviewed 56 consecutive patients submitted to surgery, divided into two groups: (1) total pelvic exenteration plus DBWC (n = 26); (2) DBWC without simultaneous pelvic resection (n = 30). Pelvic tumor recurrences accounted for most patients (n = 53), whereas the remaining three patients suffered from actinic pelvic complications. RESULTS: Surgical morbidity and mortality rates were 53.8% (14/26) and 11.5% (3/26) in Group 1, and 43.5% (13/30) and 3.3% (1/30) in Group 2, respectively. Only 2 patients out of 51 (3.9%) developed late postoperative urinary tract infection. Regression of the hydronephrosis was observed in 28 out of 33 assessable patients. Median survival in Groups 1 and 2 was 8.36 and 4.14 months, respectively. In the subgroup of patients submitted to curative surgery (n = 24), actuarial cancer-specific survival rate in 2 years was 58.78%. CONCLUSION: DBWC is a safe and efficient alternative for simultaneous urinary and fecal diversion, with low morbidity and mortality rates, improvement of renal insufficiency, and low risk of postoperative urinary tract infection.

Adult↗
PubMed1980

Mouse colostomy model for studies on large bowel cancer.

The development of appropriate animal model systems has been proposed as a means of facilitating the study of human colorectal cancer. This report describes the development and use of a blind-colorectal pouch in a carcinoma mouse model. The blind-pouch was prepared in C57BL/6J mice by surgically exteriorizing the descending colon and producing two stomata in the abdominal wall. The proximal stoma served as an end colostomy and the distal stoma created as a mucous fistula. Surgical closure of the anus thus provided a colorectal pouch. In pilot studies it was found that N-methyl-N-nitrosourea (MNU) and radiation together but neither separately produced tumors in the pouch of surviving mice. Further, inoculation of C38 syngeneic tumor cell suspension into the pouch and immediate closure resulted in tumor takes within three to four weeks. The use of this model in carcinogenesis and the immunology of colon cancer simulate the human colorectal cancer problem more closely than previous animal models.

Animals↗
PubMed1986

Metachronous leiomyosarcoma in colostomy after abdominoperineal resection for rectal carcinoma.

Leiomyosarcoma of the colon is a rare neoplasm. It is widely known that primary malignant lesions may present either simultaneously (synchronous tumor) or at different times (metachronous tumor). The incidence of metachronous colonic mucosal carcinoma is generally considered to range from 3 to 5%. Metachronous leiomyosarcoma in colostomy 4 years after abdominoperineal resection for rectal carcinoma is unusual and we have found no reports on this in the literature. The clinical symptoms, diagnostic features, and mode of treatment are discussed.

Adenocarcinoma↗
PubMed1995

Minimally raised end colostomy.

The traditional maturation of the mucocutaneous junction of an end colostomy often leads to a stoma with no significant projection above the skin. We describe a simple method which allows a small spout to be easily created. This technique has been used in 30 patients and is believed to diminish leakage. A raised stoma is easier for the patient to see and Stoma care nurses prefer them.

Colostomy↗
PubMed1988

Retrograde colostomy and ileostomy enemas in neonates and infants: a simple combination of techniques.

A combination of previously known techniques for retrograde opacification of ileostomies and colostomies has been used successfully in neonates and infants. This combination of techniques used on very small stomas allows easy retrograde opacification of bowel. The technique uses a small feeding tube, a larger Foley catheter with an inflatable balloon, and a Lucite compression device, the construction and use of which are discussed here.

Barium Sulfate↗