Authors
Khanevich M.D.1, Perminova A.A.3, Manikhas G.M.2, Fridman M.H.2, 4
1 Saint Petersburg State Pediatric Medical University, St. Petersburg
2 First Saint Petersburg State Medical University named after Academician I.P. Pavlov, St. Petersburg
3 City Clinical Hospital named after S.S.Yudin, Moscow
4 City Clinical Oncology Dispensary, St. Petersburg
Abstract
Colostomy is one of the most common life-saving surgeries performed worldwide to decompress colon obstruction. A comparative analysis of late colostomy complications was performed in patients after emergency open and endovideosurgical obstructive resections of the left half of the colon.
The aim of the study. To assess the nature of late complications of colostomies after open and endovideosurgical obstructive resections of the colon.
Materials and methods. The study included 609 patients with left colon cancer of stages I–III, who underwent temporary single-barrel colostomies after emergency obstructive resections. Resection of the colon with a tumor from laparotomy was performed in 426 (70.0%) cases, using endovideosurgical method – in 183 (30.0%). In the late period, various surgical complications arose: parastomal hernia, combination of parastomal hernia with ventral hernia, colostomy stricture, colostomy retraction, intestinal prolapse. Complications in the group of patients after open interventions arose in 289 (67.8%) patients, in the group of endovideosurgical interventions – in 98 (53.6%).
Results of the study. During the statistical analysis in the group of patients after open and endovideosurgical operations, statistically significant differences were found in complications such as parastomal hernias, a combination of parastomal and ventral hernias, colostomy stricture, and colostomy retraction. Late complications of colostomies were more common in patients after open surgeries. In the group of patients after open operations, 29 (10.1%) patients developed complications that required emergency surgery: strangulated parastomal hernia – 15 (5.2%), acute intestinal obstruction caused by stricture or retraction of the colostomy – 8 (2.8%), strangulation of the prolapsed intestine – 6 (2.1%). When performing laparoscopically assisted colostomy formation, such complications occurred in 4 (4.1%) patients.
Keywords: colorectal cancer, obstructive colon resection, colostomy, paracolostomy hernia, colostomy prolapse, colostomy stricture.
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