Perineal colostomy: an alternative to avoid permanent abdominal colostomy: operative technique,results and reflection

Background

The most common injury to indicate definitive stoma is rectal cancer. Despiteadvances in surgical treatment, the abdominoperineal resection is still the mosteffective operation in radical treatment of malignancies of the distal rectuminvading the sphincter and anal canal. Even with all the effort that surgeons haveto preserve anal sphincters, abdominoperineal amputation is still indicated, and adefinitive abdominal colostomy is necessary. This surgery requires patients tolive with a definitive abdominal colostomy, which is a condition that modify bodyimage, is not without morbidity and has great impact on the quality of life.

Aim

To evaluate the technique of abdominoperineal amputation with perineal colostomywith irrigation as an alternative to permanent abdominal colostomy.

Method

Retrospective analysis of medical records of 55 patients underwentabdominoperineal resection of the rectum with perineal colostomy in the period1989-2010.

Results

The mean age was 58 years, 40 % men and 60 % women. In 94.5% of patients theindication for surgery was for cancer of the rectum. In some patients were madethree valves, other two valves and in the remaining no valve at all. Complicationswere: mucosal prolapse, necrosis of the lowered segment and stenosis.

Conclusion

The abdominoperineal amputation with perineal colostomy is a good therapeuticoption in the armamentarium of the surgical treatment of rectal cancer.