Guzmán-Valdivia Gómez Gilberto
Research Unit, Mexican School of Medicine, Universidad La Salle, Fuentes 17, Tlalpan, CDMX 14000, Mexico.
Int J Surg Case Rep. 2021 Aug;85:106292. doi: 10.1016/j.ijscr.2021.106292. Epub 2021 Aug 8.
Stenosis of the colostomy occurs in 2-15% of patients and, they are the cause of serious discomfort for the patient due to the difficulty in evacuation, as well as the need for new surgical interventions. The purpose of this work demonstrates an outpatient surgical treatment that can be performed in the office.
Three patients with definitive colostomy who suffered progressive stenosis are presented. Under local anesthesia, one or two triangular segments, with their bases on the colostomy, which included the thickened and hardened skin, are removed to expand the diameter of the stoma. The mucosa of the colon is sutured to healthy skin with Vicryl 3/0 simple stitches. This method has been used in three patients older than 60 years with permanent colostomy who presented with progressive stenosis 6-7 months after surgery. The average follow-up at 14.5 months was satisfactory, without restenosis.
Stoma stenosis is a complication that occurs in up to 15% of cases and requires reconstruction, most of which are carried out in the operating room. The triangular stenoplasty presented is effective and is performed under local anesthesia in the office.
Triangular-section stenoplasty of a stenosed permanent colostomy is an effective outpatient treatment.
结肠造口狭窄发生于2%至15%的患者中,由于排便困难以及需要进行新的手术干预,给患者带来严重不适。本研究的目的是展示一种可在门诊进行的手术治疗方法。
介绍了3例患有永久性结肠造口且出现渐进性狭窄的患者。在局部麻醉下,切除一或两个以结肠造口为基底的三角形组织块,其中包括增厚变硬的皮肤,以扩大造口直径。用3/0可吸收缝线将结肠黏膜与健康皮肤缝合。该方法已应用于3例60岁以上行永久性结肠造口术的患者,这些患者在术后6至7个月出现渐进性狭窄。平均随访14.5个月,效果满意,无再狭窄。
造口狭窄是一种并发症,发生率高达15%,需要进行重建,其中大部分在手术室进行。所介绍的三角形狭窄成形术有效,且在门诊局部麻醉下即可完成。
狭窄永久性结肠造口的三角形狭窄成形术是一种有效的门诊治疗方法。