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Avoidance-avoidance conflict refers to a psychological situation where a person must choose between two or more unpleasant alternatives. These conflicts are particularly stressful because neither option is desirable. This dilemma is often expressed in sayings like "caught between a rock and a hard place" or "between the devil and the deep blue sea." For instance, individuals who fear dental procedures may find themselves torn between enduring a painful toothache or facing the...
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Related Experiment Video

Updated: Feb 8, 2026

Hydrodynamic Renal Pelvis Injection for Non-viral Expression of Proteins in the Kidney
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Hostile pelvis: how to avoid permanent stoma.

Giuliano Barugola1, Elisa Bertocchi2, Irene Gentile1

  • 1Department of General Surgery, Sacred Heart - Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar, Verona, Italy.

Updates in Surgery
|June 29, 2018
PubMed
Summary
This summary is machine-generated.

Delayed colo-anal anastomosis (DCA) offers a viable alternative to permanent stomas in complex rectal surgery. This laparoscopic approach demonstrates safety and feasibility, with patients showing progressive improvement in bowel function over time.

Keywords:
Colorectal surgeryDelayed colo-anal anastomosisHostile pelvisPermanent stomaRectovaginal fistula

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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Complex rectal cases often necessitate permanent stomas, impacting patient quality of life.
  • Delayed colo-anal anastomosis (DCA) is an alternative surgical technique.
  • Evaluating outcomes of DCA is crucial for complex rectal surgery management.

Purpose of the Study:

  • To report the experience with delayed colo-anal anastomosis (DCA) in complex rectal cases.
  • To evaluate short- and long-term outcomes of DCA, focusing on avoiding permanent stomas.
  • To assess functional outcomes using Wexner and Low Anterior Resection Syndrome (LARS) scores.

Main Methods:

  • Retrospective analysis of nine patients who underwent DCA between 2011 and 2016.
  • Evaluation of medical history and surgical outcomes.
  • Assessment of long-term bowel function using Wexner and LARS scores at 6, 12, and 24 months post-operatively.
  • All procedures performed laparoscopically.

Main Results:

  • No peri-operative mortality observed.
  • Two patients (22%) developed post-operative pelvic abscesses requiring re-operation.
  • Long-term complications included mucosal prolapse, anastomosis retraction, and anastomotic stricture.
  • Average LARS and Wexner scores showed progressive improvement over 24 months, indicating functional recovery.

Conclusions:

  • Delayed colo-anal anastomosis (DCA) is a feasible and safe option to avoid permanent stomas in selected complex rectal surgery patients.
  • The laparoscopic approach is safe for experienced minimally invasive surgeons.
  • Patients experience a slow but progressive improvement in continence after bowel continuity restoration.