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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

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Modified pseudocontinent perineal colostomy: a special technique.

Omaya A H Nassar¹

¹Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. Omaya_nassar@hotmail.com

Diseases of the Colon and Rectum

|May 10, 2011

Summary

This study shows a modified perineal colostomy technique for anorectal cancer patients is feasible and oncologically safe. The technique achieved high patient satisfaction with continence, reducing the need for enemas.

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Area of Science:

Surgical Oncology
Gastroenterology
Reconstructive Surgery

Background:

Abdominoperineal resection for anorectal cancer necessitates techniques to restore perineal continuity.
Pseudocontinent perineal colostomy involves creating a new sphincter from a colon segment.

Purpose of the Study:

To investigate a modified pseudocontinent perineal colostomy technique for perineal reconstruction.
To evaluate the oncological safety and functional outcomes of this reconstructive approach.

Main Methods:

Prospective cohort study involving 14 patients with T2 or T3 anorectal cancer.
Reconstruction utilized a vertical rectus abdominis myocutaneous flap with a modified perineal colostomy.
Functional outcomes assessed via questionnaires, physical exams, and manometry; continence graded by Kirwan scale.

Main Results:

Complete oncological resection (R0) achieved in all patients without perioperative mortality or need for permanent iliac colostomy.
Early complications included wound infection and flap dehiscence; late complications involved mucosal prolapse and stomal stricture.
By one year, 57% achieved complete continence (Grade A), and 93% were satisfied with continence. At median 37 months follow-up, 89% were satisfied without enemas.

Conclusions:

Total orthotopic pelvic reconstruction using autologous tissue transposition is feasible and oncologically safe.
The modified perineal colostomy technique offers a viable solution for restoring anorectal continence.
High patient satisfaction with continence was achieved, independent of regular enemas or electrical stimulation.