Colostomy and Colostomy Closure

Hines, James R.; Harris, Gerald D.

doi:10.1016/s0039-6109(16)41394-0

Cited by 40 publications

(13 citation statements)

References 16 publications

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“…intestinal evisceration at the site of a stoma is a rare event, with few reports in the literature of this complication 8,9 , which presents high morbimortality and incidence between 2 and 3.5% 10 . general morbidity associated with colostomy may vary between 20 and 30% and mortality, around 1% 8 .…”

Section: Discussionmentioning

confidence: 99%

Complication related to colostomy orifice: intestinal evisceration

Salles¹,

Saba²,

Pissinin³

et al. 2011

J. Coloproctol. (Rio J.)

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Intestinal evisceration at the site of a stoma is a rare event, with high morbimortality. Its clinical manifestation often occurs between the sixth and seventh days after surgery. The risk factors most frequently related to evisceration are: increased intra-abdominal pressure, digestive tract cancer surgery, emergency surgery and stomas in the surgical incision. The authors report the case of a male patient, aged 62, suffering from adenocarcinoma of the rectum with obstructive acute abdomen, who underwent loop transversotomy for decompression. On the fourth day after surgery, he had a bronchospasm crisis, with evisceration of ileum and colon through the colostomic hole. The association of some triggering factors, such as emergency surgery, colorectal malignant neoplasm, increased intra-abdominal pressure and technical failure of colostomy were decisive in the development of this rare peri-colostomy complication.
A evisceração intestinal desenvolvida no sítio de um estoma é um evento raro, tendo elevada morbimortalidade. Sua manifestação clínica ocorre frequentemente entre o sexto e o sétimo dias de pós-operatório. Os fatores de risco mais frequentemente relacionados à evisceração são: aumento da pressão intra-abdominal, câncer do aparelho digestório, cirurgia de urgência e estomias na incisão cirúrgica. Os autores relatam o caso de um paciente do sexo masculino, com 62 anos, portador de adenocarcinoma do reto médio com abdômen agudo obstrutivo, sendo submetido à transversostomia em alça, com finalidade descompressiva. No quarto dia de pós-operatório com crise de broncoespasmo, apresentou evisceração do cólon e íleo pelo orifício abdominal colostômico. A associação de alguns fatores desencadeantes, como a cirurgia de urgência, a doença neoplásica colorretal maligna, o aumento da pressão intra-abdominal e a falha técnica na confecção da colostomia, foram determinantes para o desenvolvimento desta rara complicação pericolostômica

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Section: Discussionmentioning

confidence: 99%

Complication related to colostomy orifice: intestinal evisceration

Salles¹,

Saba²,

Pissinin³

et al. 2011

J. Coloproctol. (Rio J.)

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“…Many authors, therefore, recommend an ad ditional proximal protective colostomy for mation. However, a high rate of complica tions ensures colostomy formation and sub sequent closure [1,4,11,14,16,22], Fur thermore, leakage rates of 6.7-15% with proximal colostomies have been reported [2,3,7,15,25], Several authors have reported that proxi mal fecal diversion provides no guarantee against anastomotic leaks, and that the mor bidity of the latter remains unchanged [5,12,21,24], With the use of staplers, the inci dence of leakage stays almost the same [23]. The use of intraluminal bypass graft was suc cessfully examined in other situations [8,[18][19][20],…”

Section: Discussionmentioning

confidence: 99%

Intrarectal Bypass Graft in Low Anterior Resection and Sigmoid Obstruction – An Experimental Study

Goldman¹,

Aladgem²,

Kahn³

et al. 1988

Eur Surg Res

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The most common causes for morbidity and mortality in colorectal resections are anastomotic leaks. In low anterior resection, the incidence of anastomotic leakage ranges from 17 to 50%. With the use of the stapler technique, leakage incidence rate remains high and ranges from 10 to 25%. Colostomy formation and closures are associated with considerable morbidity and mortality. Due to the high incidence of anastomotic leakage rate in low anterior resection, and the additional complications of diverting colostomy formation and closure, the use of a rectal stent-intrarectal bypass graft has been instituted. This is carried out by means of a silastic graft, which prevents the fecal stream and gas pressure from coming into contact with the anastomotic site at the low rectum. The efficacy of intrarectal bypass graft was examined in two high-risk surgical situations, the first in very low anterior resection and the other, after early sigmoid obstruction. In both situations the intrarectal bypass graft provided for a safe anastomosis. Even when dehiscence and early obstructions occur, the tube may prevent leakage. This procedure presents effective practical implications which obviate the need for a proximal colostomy formation, thereby eliminating the physical and psychological stress that accompanies colostomies.

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“…Die Mehrzahl der Autoren verschliel3t demgegenfiber die Colostomie zweireihig [1,4,6,10,14,20,[23][24][25]. In allen Fiillen wurde bei unseren Patienten die Colostomie mit einreihigen zweischichtigen Seiden-Knopfn~ihten verschlossen, weil wir glaubten, hierdurch am einfachsten der Gefahr einer Stenosierung im Bereich der Colostomie begegnen zu k6nnen.…”

Section: Patienten Und Methodeunclassified

Die Morbidit�t und Letalit�t des intraperitonealen Verschlusses der doppell�ufigen Transversumfistel

Wedell

Eissen

Störmer

et al. 1982

Langenbecks Arch Chiv

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The postoperative course of 104 patients, who underwent closure of a transverse loop colostomy at the Surgical Department of the Teaching Hospital Herford between 1974 and 1980 after distal resection and anastomosis of the large bowel for neoplastic or diverticular disease has been reviewed in detail. The mortality was 0.9% and the morbidity rate was 25%, including 25% wound infections and 4.8% fecal fistulas. The highest complication rate was noted, when colostomies were closed during the first 6 weeks. Wound infections and fecal fistulae did not occur more frequently than in patients with diverticulitis. The intraperitoneal procedure of transverse loop colostomy closure can be recommended as to be straightforward and safe.

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Colostomy and Colostomy Closure

Cited by 40 publications

References 16 publications

Complication related to colostomy orifice: intestinal evisceration

Complication related to colostomy orifice: intestinal evisceration

Intrarectal Bypass Graft in Low Anterior Resection and Sigmoid Obstruction – An Experimental Study

Die Morbidit�t und Letalit�t des intraperitonealen Verschlusses der doppell�ufigen Transversumfistel

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Colostomy and Colostomy Closure

Cited by 40 publications

References 16 publications

Complication related to colostomy orifice: intestinal evisceration

Complication related to colostomy orifice: intestinal evisceration

Intrarectal Bypass Graft in Low Anterior Resection and Sigmoid Obstruction &ndash; An Experimental Study

Die Morbidit�t und Letalit�t des intraperitonealen Verschlusses der doppell�ufigen Transversumfistel

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Intrarectal Bypass Graft in Low Anterior Resection and Sigmoid Obstruction – An Experimental Study