A technique of continent perineal colostomy after laparoscopic abdominoperineal resection

Perineal colostomy: advantages and disadvantages

“…According to their publication, after excision, a small incision is made in the abdominal wall, through which the colon can be pulled. In addition to creating the circumferential incisions as mentioned above, they also described folding the colon at a 90 o angle, so that it resembles the sigmoid colon [12]. Then, it is reintroduced in the abdominal cavity, and colostomy construction is finished laparoscopically with perineal assistance.…”

“…One of the most discussed aspects of perineal colostomy formation is whether the reconstructive technique and the neo-sphincter manage to substitute the natural pelvic sphincteric mechanism. In many case series, satisfactory continence (usually reported as Kirwan class up to C) can be seen in up to 93% of the patients, with or without the use of anti-diarrhoeal medicine [7,12,13,19,20]. Known reports indicate that regardless of the technique employed, perineal colostomy with reconstruction seems to achieve satisfactory continence results, as well as anticipatory bowel habits, through scheduled irrigation [4,5,21].…”

“…Santoro, 1994 [19] Italy Retrospective analysis rative complications are the most frequently reported in higher percentages when compared to abdominal end colostomy [5,7,9,12,13,22]. Table I summarizes the advantages and disadvantages of perineal colostomy based on 20 selected PubMed-indexed articles.…”

Perineal pseudocontinent colostomy: an alternative method to promote patients’ satisfaction and safety?

“…There have been a few studies assessing the technique's potential, centred around patient satisfaction and continence. Almost every report describes patient satisfaction rates beyond 80% [11][12][13][14][15][16][17]. In addition, these patient series indicate that patients were quick to adapt to their newly formed perineal colostomy and its care, and even though most patients required colonic irrigation, they were able to achieve regular bowel function through planning and controlled diet [14,15,[17][18][19].…”

“…Almost every report describes patient satisfaction rates beyond 80% [ 11 – 17 ]. In addition, these patient series indicate that patients were quick to adapt to their newly formed perineal colostomy and its care, and even though most patients required colonic irrigation, they were able to achieve regular bowel function through planning and controlled diet [ 14 , 15 , 17 – 19 ]. In other words, the perineal colostomy method seems to allow for a great number of patients to not alter their behaviour and achieve a level of bowel control that in many instances matches their preoperative status.…”