2. Temporary Colostomy; Its Constrution and Closure

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The object of temporary colostomies is diversion of intestinal content from the lesions in lower bowel and they are predisposed to be closed when the primary object is achieved. Their prerequisite threfore, is easiness and safety in the procedures of construction and closure.<BR>For those purposes, loop colostomy is most fitted when the techniques of primary opening, mucocutaneous suturing and mucosal eversion are applied. Instantaneous opening of the stoma immeduately resolves the obstruction in lower bowel and there has not been a case that was complicated with peritonitis or infection of abdominal wall even if the stoma was opened instartly in a patient of bowel obstruction without satisfactory preparation of the bowel.<BR>Owing to mucocutaneous suturing, inflammatory reaction around the stoma is minimized with the result of minimal formation of cicatrical tissues. Therefore, stenosis of the stoma is prevented and on the occasion of closure, the possibility of closing the stoma merely by suturing the opening is increased. However, meticulous separation of adhesion and removal of cicatrices are required.<BR>No serious complications are yet experienced in our 25 cases of temporary colostomies except 2 cases of herniation around the stoma in elderly patients which was corrected operatively with success.
日本大腸肛門病学会の論文