Bail J P, Juglard G, Framery D, Deligny M, Charles J F
Service de Chirurgie digestive et endocrinienne F.X. Bichat, CHRU A. Morvan, Brest.
Presse Med. 1994 Nov 19;23(36):1651-4.
Irrigating colostomies allows patients to achieve nearly complete fecal continence using a simple technique. We assessed long-term results in our series of 432 patients.
From 1979 to 1992, we followed 432 patients who had undergone definitive colostomy surgery (mean follow-up = 8.4 years).
Colonic irrigation was impossible in 281 cases mainly due to retarded patient information (42%) or patient incapacity (31%). It was possible in 151 patients (globally 31%). In patients with abdominoperineal amputations the rate was 63%, for Hartmann procedures 17% and for derivations 6%. Most of the derivations were supraombilical colostomies (n = 51) including 6 who used colonic irrigation. No complications related to the technique were observed and minor incidents (usually problems with the cannula and/or pain) occurred in 61 patients. Thirteen patients (9%) abandoned the technique including 5 who complained of incontinence.
Based on these observations, we conclude that colonic irrigation is not used enough. The key to success is a quality stomy and early patient information and training. This technique is particularly adapted for active patients. It is performed every 48 hours and lasts about 35 minutes.
结肠造口冲洗可使患者通过一种简单技术实现近乎完全的大便失禁。我们评估了我们这组432例患者的长期结果。
1979年至1992年，我们对432例行确定性结肠造口手术的患者进行了随访（平均随访时间 = 8.4年）。
281例患者无法进行结肠冲洗，主要原因是患者信息滞后（42%）或患者无能力（31%）。151例患者可以进行结肠冲洗（总体占31%）。在腹会阴切除术患者中，冲洗率为63%，Hartmann手术患者为17%，改道术患者为6%。大多数改道术是脐上结肠造口术（n = 51），其中6例使用结肠冲洗。未观察到与该技术相关的并发症，61例患者出现轻微事件（通常是插管问题和/或疼痛）。13例患者（9%）放弃了该技术，其中5例抱怨大便失禁。
基于这些观察结果，我们得出结论，结肠冲洗的使用还不够充分。成功的关键是高质量的造口以及早期的患者信息和培训。这项技术特别适合活跃的患者。每48小时进行一次，持续约35分钟。
