The digestive tract ostomy is degree of difficulty which is equal to surgery for appendicitis and hernia repair.Therefore there is a need for a fixed pattern of such procedures. It is thought that the standardization of operation is to be generally accepted.There is not much difference in the maneuver and methods, and it may be almost established when some documents about loop stomy is compared. Following points need to be considered.A Preoperative stoma site marking:A few points should be marked on flat place of rectus abdominis muscle with distance from a bone. Choice of intestine: The is no tension in the induced intestine and it goes through rectus abdominis muscle and keep enough height of stoma. The height of stoma should be kept 1 cm with small intestine in mind, and 1-2 cm with colon. TheAbdominal cannel and size: The incision of peritoneum should be shorter than the skin incision and intestine should be went through rectus abdominis muscle in order to avoid prolapse and parastomal hernia.
Complications after intersphincteric resection related to defecation disorder include increase in stool frequency, urgency of defecation, and fecal incontinence. When the use of an absorbent pad is continued, the defecation function improves over time and then levels out after approximately two years. Anal manometry is used to monitor the defecation function, but there is often a poor correlation between the findings from manometry and the actual defecation situation. Proctectomy preserving the anus has decreased retention and stool storage function, and retention of the intestinal tract contents is difficult. The sphincter muscle of the anus is weakened by ISR, incurring functional disturbance and defecation abnormality with decreased QOL for the patient. Changes in physiological function are caused not only by operative anatomical changes but also by the therapeutic methods including preoperative chemoradiotherapy, reconstruction method, and any complications such as anastomotic leakage. In order to improve the indications for surgery and reduce postoperative functional disorders, further studies and more precise preoperative evaluation methods are needed.
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