Reсonstructive operations in pateients with single-barrel colostomy

Introduction. According to WHO, the number of people with stoma approaches to 100–150 people per 100,000 population. Currently a significant number of patients require reconstructive surgery.

Purpose of the study. To improve the results of reconstructive operations in patients with single-barrel colostomy.

Materials and methods of research. We monitored 96 patients with single-barrel colostomy, age 23–85. Stoma was formed during surgical interventions: after resection of the colon for cancer - in 61 patients (63,5 %), in 29 (30,2 %) – due to complications of diverticular disease of the colon, in 6 (13,5 %) – due to traumatic colon injury. Subsequently, 66 patients within 3 months to 4 years, underwent reconstructive surgery - elimination of the stoma and formation of a colorectal anastomosis. 30 (45 %) were men and 36 (55 %) women.

Treatment results. Postoperative complications detected in 5 (7,5 %) of 66 operated patients. 4 (6 %) cases had suppuration of the postoperative wound. Another 1 (1,5 %) patient was diagnosed with incompetent transversorectal anastomosis causing diffuse purulent peritonitis, resulting in death from progression of abdominal sepsis and multiple organ failure.

Conclusion. For more than 2/3 of patients with a single-barrel colostomy, it is possible to perform a reconstructive operation involving elimination of the stoma within 4–12 months. When performing reconstructive surgery, factors to be considered are metabolic status of the patient, and the condition of the stoma. Prior to surgery, the surgeon must select the type of intestinal anastomosis (mechanical or manual) and the optimal method to form an anastomosis (end to side or end to end), taking into account the anatomical features of the pelvis and preserved rectum.

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