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Trephine Ostomy: Safe and Simple | 38573

外科: 現在の研究

ISSN - 2161-1076

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Trephine Ostomy: Safe and Simple

Aykut Soyder and Hedefzgn

Introduction: Fecal diversion is often indicated in perineal sepsis and palliation of anorectal malignancy. This can be performed without recourse to laparatomy. This study was aimed to assess the outcome of trephine to loop sigmoid colostomy creation.

Materials and Methods: Trephine Loop Sigmoid Colostomy (TLSC) creation was evaluated retrospectively in unselected 23 consecutive patients including the data related with patient demographics, ASA grade, anesthetics used and surgical complications.

Results: Between January 2008 and June 2012, 23 patients (17 men, 73.9% and 6 women, 26.1%) underwent a TLSC. The mean ages of cases were 58.2 ± 15.8 (ranged 34-83). The indications for stoma formation were perineal sepsis in 11 (47.8%) cases (Figure 2), inoperable anorectal cancer in 7 (30.4%) (Figure 1), recto-vaginal fistula in 2 (8.7%), fecal incontinence in 2 (8.7%) and sigmoid volvulus in 1 (4.3%). Nine (39.1%) had surgery under regional anesthesia because of being in ASA grade III. One (4.3%) had laparotomy on the postoperative period due to colostomy descent.

Conclusion: TLSC formation is a minimal invasive method and is a basic and fast fecal diversion technique performed easily in not only those without laparotomy indications, but also in high risk patients with low complication rates.

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