Temporary colostomy--an outmoded procedure? A report on the intracolonic bypass.

The intracolonic bypass is a procedure preventing the gastrointestinal secretions and fecal contents from coming into contact with an anastomotic closure site without interrupting the intraluminal continuity of fecal flow from proximal to distal colon. Experimental and clinical data have indicated that the intracolonic bypass can protect such an anastomosis, in the presence of maximal colonic loadings, dehiscences, and fecal peritonitis. This single stage procedure obviates the necessity for construction and subsequent closure of a temporary colostomy in situations where it is currently indicated; the morbidity, mortality, psychologic problems, and economic costs associated with these multiple procedures are avoided. Sufficient experience now has been gained to recommend the intracolonic bypass as a viable alternate to temporary colostomy.