[25 years experience with the anastomotic stoma]

The anastomotic stoma is used since more than 25 years in emergency surgery of the bowel. To avoid a high risk primary anastomosis or a second laparotomy for reconstruction of the continuity, this procedure is performed, if sufficient bowel loop mobilization is possible. After resection of the diseased bowel segment, the proximal and distal loop are brought together and the posterior wall is then anastomized. The anterior wall of the anastomosis remains open and is fixed to the abdominal wall as a stoma. So far we have used this method in 136 patients. In 117 cases this technique was performed during emergency operations. No patient died as a result of complications of the method; 48 patients, however died due to the primary disease. Bowel continuity could be restored in 100 cases. The anastomotic stoma protects the posterior wall from elevated pressure and allows daily control of the anastomosis. In the case of extraperitoneal closure, a secondary laparotomy for reconstruction of the continuity is not necessary. The anastomotic stoma can be performed in most regions of the small and large bowel.