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Optimal Colostomy Placement in Spinal Cord Injury Patients.

Jiashou Xu1, Sekhar Dharmarajan, Frank E Johnson

  • 1Department of Surgery, Saint Louis University Medical Center, Saint Louis, Missouri, USA.

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|April 22, 2016
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Summary
This summary is machine-generated.

Sigmoid colostomy is the optimal surgical approach for fecal management in spinal cord injury (SCI) patients. This procedure, particularly the laparoscopic technique, offers favorable long-term outcomes and is not technically difficult to perform.

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Area of Science:

  • Colorectal Surgery
  • Spinal Cord Injury Management
  • Gastrointestinal Surgery

Background:

  • Fecal incontinence and constipation are significant challenges for patients with spinal cord injury (SCI).
  • Effective bowel management is crucial for maintaining quality of life and preventing complications in SCI individuals.

Purpose of the Study:

  • To provide evidence supporting sigmoid colostomy as an effective and manageable surgical option for fecal management in SCI patients.
  • To evaluate the long-term results and procedural feasibility of sigmoid colostomy in this population.

Main Methods:

  • Retrospective review of operative notes for SCI patients undergoing colostomy for fecal management.
  • Analysis of data from 27 operations performed by ASCRS-certified colorectal surgeons between 2007 and 2012.
  • Focus on 14 evaluable patients with traumatic SCI who underwent either laparoscopic or open sigmoid colostomy.

Main Results:

  • Sigmoid colostomy was identified as the optimal technique for fecal management in SCI patients.
  • Laparoscopic sigmoid colostomy was performed in 12 out of 14 evaluable SCI patients.
  • The procedure was successfully performed even in a complex case with extensive retroperitoneal bony debris.

Conclusions:

  • Sigmoid colostomy is the consensus optimal procedure for fecal management in spinal cord injury patients.
  • Laparoscopic sigmoid colostomy is the preferred surgical approach due to its efficacy and feasibility.
  • Healthcare providers should consider and specify sigmoid colostomy when consulting surgeons for SCI-related bowel management issues.