Álvarez-Ponce Carlos Eduardo, Barrios Elizabeth, López-Gómez Javier, Rosas-Guerra Oscar Xenon, Perez-Yañez José de Jesus, Meneses-León Joacim, Ramírez-Ramírez Armando
Department of Oncologic Surgery, Juarez Hospital of Mexico, Mexico City, Mexico.
Planning, Development and Statistics Department Director, Civil Service Social Security and Services Institute ISSSTE, Mexico City, Mexico.
Int J Surg Case Rep. 2020;77:378-382. doi: 10.1016/j.ijscr.2020.11.005. Epub 2020 Nov 7.
Intestinal stomas are created for distinct clinical conditions. They may involve the small bowel (ileostomy) or the large bowel (colostomy), depending on the objective or site of the stoma. Intestinal stomas may be temporary or permanent; they cause loss control of intestinal transit due to the absence of a sphincter that regulates its exit, provoking a continuous passage of fecal matter through the stoma. Within the environment of the ostomized patients, there are several important complications involving their quality of life.
The Intestinal Valve Type Artificial Sphincter (VITEA) device is placed in a patient diagnosed with cervical cancer, who has a vaginal-rectum fistula that requires a definitive colostomy.
Intestinal stomas have been validated for over a century. We present the case with a similar complication rate to those described after performing a stoma with conventional open technique in terms of quality of life and cost-benefit ratio. The proportion of complications and the quality of life found in the ostomized patient with the VITEA* device is acceptable, and also eliminates the colostomy bags, providing the function of an artificial sphincter by everting the mucosa on the same device. No complications were found during the follow-up.
The results from this proposal will allow to evaluate the safety and efficacy profile associated with a stomal bags.
肠道造口是针对不同临床情况而创建的。根据造口的目的或部位，它们可能涉及小肠（回肠造口术）或大肠（结肠造口术）。肠道造口可能是暂时的或永久的；由于缺乏调节排泄物出口的括约肌，它们导致肠道运输失去控制，促使粪便持续通过造口排出。在造口患者的环境中，存在一些影响其生活质量的重要并发症。
将肠道瓣膜型人工括约肌（VITEA）装置植入一名被诊断患有宫颈癌且患有阴道直肠瘘并需要进行永久性结肠造口术的患者体内。
肠道造口已经有一个多世纪的历史了。就生活质量和成本效益比而言，我们呈现的这个病例的并发症发生率与采用传统开放技术进行造口术后所描述的情况相似。使用VITEA*装置的造口患者出现的并发症比例和生活质量是可以接受的，而且还省去了结肠造口袋，通过使同一装置上的黏膜外翻来提供人工括约肌的功能。随访期间未发现并发症。
该方案的结果将有助于评估与造口袋相关的安全性和有效性。
