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THE USE OF THE SEROMUSCULAR TISSUE OF THE LARGE BOWEL AS A "SPHINCTER" FOR THE CREATION OF CONTINENT COLOSTOMY

By ΔΗΜΗΤΡΙΟΣ ΛΙΩΤΗΣ

Abstract

THE PURPOSE OF THIS DISSERTATION IS THE CREATION OF A PERMANENT, FINAL, CONTINENT COLOSTOMY WITH A "SPHINCTER" OF AUTOLOGUS SEROMUSCULAR TISSUE OF THE LARGE BOWEL. METHODOLOGY: IN 17 PATIENTS WITH CA OF LOW RECTUM WHO HAD BEEN SUBJECTED TO ABDOMINOPERINEAL RESECTION OF THE RECTO-SIGMOID THE SCHMIDT METHOD WAS APPLIED, THAT IS RESECTION OF THE FAT FROM 16 AND OF THE MUCOSA OF THE 10 LAST CM OF THE COLONSTUMP, CREATING THUS COLOSTOMY WITH AN ARTIFICIAL "SPHINCTER".THE FOLLOWING MODIFICATIONS WERE TAKEN PLACE: 1) RESERVATION OF THE WHOLE ADIPOS-VASCULAR STALK. 2) INCREASE OF THE PRETENSION IN 140% AND THE SPHINCTERTONE IN THE TRIPLE OF THE PRESSURE OF THE COLON IN A CALM PHASE. 3) EXTRRAPERITONEAL LOCATION OF THE "SPHINCTER" AND AN OUTPUT OF THE STOMA THROUGH T HE RECTUS ABDOMINAL MUSCLE. 4) CREATION OF SYMPHYSES WITH SUTURES BETWEEN THE COLON OF FOR THE SPHINCTER AND THE PERITONEUM OF THE ABDOMINAL WALL FOR THE EXPLOITATION OF ITS GREAT SENSIBILITY AND THE PERITONEOINTESTINAL REFLECTIONS. RESULTS-CONCLUSIONS: A FTER ENEMA ACHIEVEMENT OF A 24 HOURS CONTINENCE AND A PROMPT PERCEPTIBLE URSING BOWELMOVEMENT IN THE 16 PATIENTS. THE METHOD IS EASILY APPLICABLE WITHOUT SUBSTANTIAL COMPLICATIONS AND FINANCIAL COST; FURTHERMORE OUR MODIFICATIONS IMPROVED THE RESULTS OFFER ING A VERY GOOD QUALITY OF LIFE.

Topics: COLOSTOMY, CONTINENT STOMA, Incontinence, SMOOTH MUSCLE, SPHINCTER CREATION, Ακράτεια, ΔΗΜΙΟΥΡΓΙΑ ΣΦΙΓΚΤΗΡΑ, ΕΓΚΡΑΤΗΣ Η ΣΤΕΓΑΝΗ ΣΤΟΜΙΑ, Κολοστομία, ΛΕΙΟΣ ΜΥΙΚΟΣ ΙΣΤΟΣ
Publisher: Aristotle University Of Thessaloniki (AUTH)
Year: 1998
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