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PubMed1994

Laparoscopy-assisted colostomy.

The surgical modality of laparoscopic cholecystectomy is now widely accepted, and other intra-abdominal operations are also being done laparoscopically. This paper presents a case of laparoscopy-assisted colostomy in which a complete obstruction of the sigmoid colon associated with intraperitoneal dissemination and massive ascites in the end-stages of ovarian cancer was encountered. This procedure was found to be less invasive and thus should be considered the treatment of choice for an obstruction of the gastrointestinal tract in patients with a poor general status.

Aged↗
PubMed1995

Trephine colostomy: a warning.

A case of trephine colostomy is presented in which air insufflation incorrectly identified the distal limb. Disaster was averted by correct identification at laparotomy. The probable cause of the error and methods of avoidance are discussed.

Colostomy↗
PubMed1996

[Colonic irrigation for colostomies. Results of a national survey among 795 colostomized patients].

Colonic irrigation (CI) represents the procedure of choice for patients with a colostomy. Recent technical advances (irrigation kit) have provided patients with simple, safe and effective material, allowing a new expansion of this old concept. A total of 795 colostomates (from association's data base) were assessed by questionnaires 386 (49%) of them used CI: 43.5% of patients operated before 1980 and 50% after 1980 (p < 0.005). Two thirds of patients performed Cl every two days, in the morning, with one liter or less of water, for 45 to 60 minutes. No morbidity was reported. Some patients (18%) stopped the procedure deliberately, but none due to a complication. Total continence during 48 H was observed in 48.4% of patients. Wearing a classical stomabag after CI must be considered to be a precaution rather than a failure. However one half of patients wore a simplified material (minibag, obturator, sticking plaster). The vast majority of patients (86%) claimed to be entirely satisfied with CI and 96% wanted to continue the procedure as long as possible.

Adult↗
PubMed1996

[Comparative study of 2-piece colostomy systems (ConvaTec Combihesive Flexible, Coloplast 2002 and Hollister Guardian in the Czech Republic)].

In three surgical centres in the Czech Republik three modern two-piece colostomic systems where compared which are at present available in the Czech republik, incl. an attempt to assess how they influence the quality of life of the patients. The investigation comprised 117 patients mean age 59 years-93 after colostomy, 13 with ileostomy. The investigated systems were ConvaTec Combihesive Flexible, Coloplast 2002, Hollister Guardian two-piece ostomy systems with a closed sac and inner filter. The main investigated parameters were: tolerance of the products, preference expressed by the patient, the state of the skin beneath the plaster and the index of general health (GWBI). From the investigation ensued that in the Czech Republic the system ConvaTec Combihesive proved very useful and there probably will not be a demand for a change to another system offered by distinguished producers, as such a change would not entail any advantages. It was revealed that when the ConvaTec Combihesive system is used, the skin is maintained in a good condition which has a favourable impact on the feeling of wellbeing and improves the quality of life.

Colostomy↗
PubMed1995

[Compression suturing devices in surgery of lateral colostomies].

The Authors refer their experience about two cases of colo-colic anastomosis executed by employment of biofragmentable ring BAR (Valtrac). The Authors used, for the bowel fragments preparation, the ASP-50 rake, overcoming the frequent inconvenient of mucosa extroversion thanks to circumferential mucosectomy extensive for a few mm. of colic fragments. Based on BAR (Valtrac) behaviour and the obtained results, in accord with the most other Authors, they conclude affirming that the compression anastomosis represents a simple methodology, sure and reliable for closing of the lateral colostomies.

Anastomosis, Surgical↗
PubMed1998

[Proximal colostomy in multistage treatment of complicated colonic diverticulosis].

On the basis of experience in surgical treatment of 128 patients with colonic diverticulosis who had a proximal colostoma which was formed earlier for acute complications of the process, it is shown that colostomy is inadequate as an independent method for the management of complicated diverticulosis. Resection or exteriorization of the involved segment of the large intestine is necessary in such cases. The formation of entero-enterostomy is hazardous and inexpedient in that event.

Adult↗
PubMed1976

[Artificial anus. Advantages and disadvantages of ileo- and colostomy].

The majority of patients with ileostomy adapt to their new situation and are able to live a nearly normal professional and social life. This does not mean that there is not a need for improvement in the ileostomy construction. It merely proves the great adaptive mechanism in man. In spite of the improvement in surgical techniques in the construction of the ileostomy and the development of modern ileostomy appliances, a proportion of the patients still experiences serious problems. In order to improve the situation for patients with ileostomy a new type of ileostomy has been developed. From the terminal ileum an intraabdominal, intestinal reservoir is constructed and the outlet from the reservoir is provided with a "nipple valve" preventing leakage of gas and faeces through the outlet. The continent ileostomy has now been under clinical trial for more than seven years. The success-rate has increased along with improvements in technique and introduction of methodological modifications. More than 90% of 164 patients provided with this type of ileostomy had at follow-up satisfactory functional results of their ileostomy. That means that they had no need for carrying external ileostomy appliances. A method for constructing a continent colostomy has been tested in dogs. The sigmoid colon was divided and the distal end closed. At the proximal end a "nipple valve" was constructed by intussuscepting a part of the intestine into its lumen. All dogs were continent from the time of operation until they were sacrificed one to eight weeks later. The method is now under elaboration for clinical trial.

Animals↗
PubMed1998

[Accidental destruction of a colostomy. Case report].

The case which we describe in the following article is an example of the application of new advances in stomatology as well as an example of perfect coordination among medical professionals. A basic element for high quality health care. We describe the accidental removal of a loop colostomy with detachment and colaspe of the stoma and the corresponding treatment followed in order to maintain the viability of the stoma. Finally, we mention the advantages obtained in choosing a conservative treatment for this kind of complicated stomas.

Aged↗
PubMed1998

[Percutaneous drainage of peri-sigmoid abscesses or how to avoid colostomy].

BACKGROUND: Percutaneous drainage can be a conservative option for abscess formation subsequent to acute inflammation of the sigmoid colon. CASE REPORTS: Three patients, aged 36, 65 and 77 years, were hospitalized for abscesses in the peri-sigmoid region. All three were treated with echoguided percutaneous drainage. The infectious phenomena regressed rapidly allowing secondary left colectomy 6 to 8 dais later with immediate colorectal anastomosis. DISCUSSION: Hartman's resection is indicated for perforated diverticules of the sigmoid colon with formation of pelvic abscess and must be followed by a second laparotomy to re-establish colo-rectal continuity. Percutaneous drainage can successfully treat the acute septic component an allow planning the surgical procedure later in better conditions. With percutaneous drainage, temporary colostomy can be avoided in selected patients.

Abscess↗
PubMed2005

Single-stage operation without temporary colostomy for persistent cloaca with a short common channel.

Colorectal decompression with a catheter was performed for evacuation of stool before definitive surgery in two patients with a persistent cloaca. Two newborn female infants with persistent cloaca received placement of a silicone balloon-tipped catheter in the rectum via the cloacal orifice under fluoroscopic guidance at the time of diagnosis. The length of the cloaca was 2 and 1.5 cm, respectively. The diameter of the catheter was matched to the patients' rectal size and the open end was wrapped in a diaper to allow continuous drainage of stool. The infants underwent bowel irrigation with warm saline thrice a day, at home. Total urogenital mobilization was carried out in the infants at the age of 7 and 8 months, respectively. Both infants had no abdominal distension, colorectal dilatation, or urinary tract infection while the catheter was in situ. The postoperative course was uneventful, except for minimal wound dehiscence in one patient. At present, both infants can void spontaneously without any urological problems. In infants with a persistent cloaca less than 3 cm long and normal urinary tract function, adequate evacuation of stool may be achieved by colorectal decompression with a catheter, thus avoiding the need for a colostomy.

Cloaca↗
PubMed1997

Simultaneous radical prostatectomy and partial rectum resection without colostomy.

The simultaneous occurrence of carcinoma of the rectum and prostate is observed in 6%. Ablative surgery in two sessions is technically more difficult than in a single session. This is demonstrated by the successful outcome of a patient treated for such a double carcinoma without colostomy. In contrast to an accidental rectal injury, the thorough bowel preparation in this planned procedure enabled a single-session resection of the two cancers.

Anastomosis, Surgical↗
PubMed1996

Avoiding Colostomy With Conservative Multimodality Management of Distal Rectal Cancer.

While abdominoperineal resection with permanent colostomy has been the surgical benchmark in the treatment of distal rectal carcinoma, different approaches to treatment have been sought for decades to decrease the morbidity and mortality associated with radical surgical procedures for this disease. The advent of alternative methods of sphincter preservation that afford excellent functional results has led to a decline in the incidence of abdominoperineal resection. With appropriate patient selection, accurate preoperative staging data, and the selection of a surgical approach appropriate to the tumor stage, conservative surgical approaches now can be considered in the treatment of cancer at every level of the rectum.

Journal Article↗
PubMed2005

The rectus sling to prevent loop colostomy retraction: a case series.

Diverting stomas are being used increasingly in the management of rectal cancer, particularly with low anterior resection following neoadjuvant therapy. We describe a simple anchorage method for loop colostomy using a rectus fascial sling. This has been used successfully in fifteen patients with no complications or evidence of significant spill over of faecal contents into the efferent loop.

Journal Article↗