Berrada S, Khaiz D, Alloubi I
Département de chirurgie, quartier des hôpitaux, CHU de Casablanca, Casablanca, Maroc.
Ann Chir. 2005 Jan;130(1):15-20. doi: 10.1016/j.anchir.2004.06.006.
This prospective study was designed to evaluate functional results of a pseudocontinent perineal colostomy (PCPC) using Schmidt's technique.
Functional results in eight patients whose rectum were resected due to cancer or anal epidermoid carcinoma and reconstructed by PCPC between January 1995 and July 2002 in our institution were evaluated. Surgical technique and post-operative care were described. Morbidity, functional results and degree of patient satisfaction were reported. Median follow-up was 40 months (18-70 months) and was completed in 100% of patients.
There were no operative deaths. Four patients had post-operative complications, whose two patients had partial disunion of sutures, and two patients had urinary infection that was treated by adequate antibiotherapy. No conversion to a definitive abdominal colostomy was performed. On a functional level, one patient has normal continence, six had gas incontinence, and one has occasional minimal soiling. Seventy-five percent of patients were either highly satisfied with their continence.
PCPC is a reliable technique, which can be proposed as an alternative to a left iliac colostomy following amputation of the rectum due to cancer, provided that certain requirements are met: careful selection of patients, informed consent, flawless surgical technique and lifetime daily colic irrigation.
本前瞻性研究旨在评估采用施密特技术的假 continent 会阴结肠造口术（PCPC）的功能结果。
对1995年1月至2002年7月间在我院因癌症或肛门表皮样癌行直肠切除并采用PCPC重建的8例患者的功能结果进行评估。描述了手术技术和术后护理。报告了发病率、功能结果和患者满意度。中位随访时间为40个月（18 - 70个月），所有患者均完成随访。
无手术死亡病例。4例患者出现术后并发症，其中2例患者缝线部分裂开，2例患者发生泌尿系统感染，经适当抗生素治疗。未行转为确定性腹部结肠造口术。在功能方面，1例患者控便正常，6例患者有气体失禁，1例患者偶尔有少量粪便污染。75%的患者对其控便情况高度满意。
PCPC是一种可靠的技术，在满足某些要求的情况下，可作为因癌症行直肠切除术后左髂结肠造口术的替代方法：仔细选择患者、知情同意、完美的手术技术和终身每日结肠灌洗。
