The Results of Applying the Original Colostomy in Patients with Acute Large Bowel Obstruction

Abstract

The results of the original method of colostomy formation in 67 patients with acute large bowel obstruction (ALBO) were studied. All patients underwent sigmoid colon resection with the colostomy formation. In total, postoperative complications of a purulent-inflammatory nature (skin maceration, suppuration of postoperative and paracolostomic wounds, necrosis of colostomy, abscess of the abdominal cavity, and paracolostomal fistula) in both groups were observed in 30 (44.8%) patients. In Group 1 (n=40), with the classical method of colostomy formation, purulent-inflammatory complications were observed in 21 (52.5%) patients, in Group 2 (n=27) with the original method of colostomy formation in 4 (14.8%) patients. Bleeding from colostomy and colostomy prolapse occurred only in Group 1 in 8 (20%) patients. The proposed method of applying a colostomy helps reduce purulent-inflammatory complications by more than 3 times and provides prevention of bleeding and colostomy prolapse.

Analysis of the Early Postoperative Complications in Patients with Acute Malignant Bowel Obstruction

“…(4)(5)(6) In most cases, the cause of acute intestinal obstruction is cancer of the descending colon and rectum. (1,3,7,8) Up to 30% of newly diagnosed colon cancers present with acute intestinal obstruction, particularly in the case of left-sided tumors. (9) The leading method of treatment for acute malignant bowel obstruction (AMBO) is surgery.…”

“…(12,13) According to data in the literature, the failure of the colonic anastomosis is one of the frequent and formidable postoperative complications, leading to death, recurrence of the disease and shorter life expectancy. (1)(2)(3)7,8) To prevent this complication and eliminate the load on the colonic anastomosis, colostomy is performed. Currently, most foreign (4)(5)(6) and domestic (1)(2)(3)7,8) clinical recommendations recommend imposing a temporary colostomy during resection of the large intestine due to AMBO.…”

“…The possible complications of a colostomy are skin maceration, suppuration of postoperative and paracolostomy wounds, colostomy necrosis, abscess of the abdominal cavity, paracolostomy fistulas, colostomy prolapse, parasthomal hernia, etc. (1)(2)(3)7,8) The incidence rate of the above complications ranges from 1% to 50%. (1)(2)(3)7,8) Violations of the surgical technique, the presence of severe concomitant pathology, and reduced immunity in patients with AMBO are leading factors in the occurrence of paracolostomy complications.…”

“…(1)(2)(3)7,8) The incidence rate of the above complications ranges from 1% to 50%. (1)(2)(3)7,8) Violations of the surgical technique, the presence of severe concomitant pathology, and reduced immunity in patients with AMBO are leading factors in the occurrence of paracolostomy complications. (2,3,(6)(7)(8) The aim of our study was to analyze early postoperative complications in patients with colon cancer complicated by AMBO.…”