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[Pseudo-continent perineal colostomy. Results and techniques]
P Lasser1, P Dubé, J M Guillot
1Département de Chirurgie, Institut Gustave-Roussy, Villejuif.
Journal De Chirurgie
|March 21, 1998
Summary
Pseudo-continent perineal colostomy offers a reliable alternative for rectal cancer patients, with 86% satisfaction despite some incontinence. Careful patient selection and surgical technique are crucial for success.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastroenterology
Context:
- Rectal cancer treatment often necessitates abdominoperineal resection, leading to permanent colostomy.
- Developing continent or near-continent diversion techniques is a significant goal in reconstructive surgery.
- The Schmidt procedure for pseudo-continent perineal colostomy aims to improve functional outcomes and patient quality of life.
Purpose:
- To prospectively evaluate the functional results and patient satisfaction following pseudo-continent perineal colostomy (Schmidt procedure).
- To assess the morbidity and long-term outcomes of this reconstructive technique in patients undergoing rectal amputation for cancer.
Summary:
- Forty patients undergoing rectal amputation for cancer and subsequent pseudo-continent perineal colostomy were assessed.
- No operative deaths occurred; however, 20 patients experienced post-operative complications, with 2 requiring conversion to abdominal colostomy.
- Functional outcomes included normal continence (4), air incontinence (23), occasional leakage (9), and severe incontinence (2).
Impact:
- Pseudo-continent perineal colostomy demonstrates reliability as an alternative to traditional colostomy after rectal amputation.
- High patient satisfaction (86%) suggests the procedure positively impacts quality of life.
- Successful implementation requires meticulous patient selection, informed consent, precise surgical technique, and consistent post-operative irrigation.