Colostomy - a surgical procedure in which a portion of the colon is displayed through an opening in the abdominal cavity. Created opening called a stoma or a colostomy, it is attached Colostomy bags. The stoma may be temporary or permanent.
The human digestive system consists of five main structures:
- Stomach - a body in which the food is processed with acid and moves into the small intestine.
- Small intestine - long and thin parts of the digestive system, which absorbed most of the nutrients from the food, and the remaining liquid moves into the large intestine.
- Colon - the lower part of the intestine from the small intestine to the line, where undigested food thickens the liquid is absorbed. Bacteria break down food residues, transforming them into feces. Content using the muscle layer moves into the rectum.
- Rectum - the area intended for the storage and evacuation of feces.
- Anus - opening at the lower part of the rectum, through which stool leaves.
The need for a colostomy arises in connection with serious violations of the colon. Some of the most common reasons for the formation of a stoma:
- bowel cancer.
- Crohn's disease.
This is one of the most frequent malignant disease, which mainly affects the colon or rectum. Widely used surgical removal of the affected part of the bowel.
If the removed part of the colon, creates a temporary colostomy to the operated segment of the body not exposed to feces. Then the colon combined and clean the stoma.
When the rectum is removed, as a rule, there is a need in the permanent colostomy. The same with the anus resection.
This is a condition in which there is an inflammation and infection of diverticula. Diverticulitis is abdominal pain, fever and vomiting.
First, the disease is treated with antibiotics, but at repeated episodes recommended removing lesions of the colon. It may require a temporary colostomy, who underwent surgery until the segments will heal.
Severe constipation, colon cancer and other diseases or herniation can cause obstruction. She, in turn, is a medical emergency, as there is the risk of rupture of the colon, causing infection and internal bleeding.
In some cases, it is necessary to remove part of the colon, imposing a temporary or permanent colostomy. If the body is removed completely, required the creation of a temporary or permanent ileostomy.
This is a condition in which a person is not able to control the act of defecation. Colostomy surgery is used as a last resort, when all other conservative and surgical treatments have failed.
If part of the colon has been removed as a result of knife or gunshot wound, it may require the imposition of a stoma, temporarily or permanently.
Colostomy in Children
Hirschsprung's disease is a major cause of colostomy surgery in children. This is a rare genetic disease that affects 1 in 5,000 children.
When the disease are missing the nerves that control the muscles of the colon, which easily leads to the obstruction. That prevent it, sometimes you need a colostomy operation. During its execution portion intestine where there are no nerve endings is removed and the stoma is formed, temporary or permanent, depending on the number of resected organ.
Colostomy in Israel
There are several colostomy operations. Application specific methodologies in clinical diagnosis Assuta depends on:
- Open surgery (laparotomy) is performed through an incision in the abdominal cavity to remove the affected area of the colon.
- Laparoscopic surgery. The surgeon makes small incisions, through which introduces a miniature video camera and special surgical instruments for resection of the affected colon segments. In cases where it is possible to use, laparoscopy is the most preferred option. Studies have shown a faster recovery process and reduce the risk of complications.
However, in emergency situations, such as ileus, minimally invasive surgery may not be available, so operate cavitary intervention.
All kinds of colostomy surgeries are performed under general anesthesia.
There are two main types of colostomy - and loop end. Consider their features and performance of the clinic Assuta.
To create a loop segment of the colon is removed via an incision in the abdominal skin surface. It is opened and sutured to the skin, creating a colostomy. It will have two holes to the outside displays two branches. This stoma is called a double-barreled. One opening is connected with the functioning of the intestines, the waste removal from the body, the other with the "inactive" part of the intestine, leading to the rectum, and produces a small amount of mucus.
Regulation colostomy will depend on which segment of the colon is removed. Usually stoma is located on the left side of the abdomen, below the belt line. Before the surgery, discusses options for its placement.
After surgery, a colostomy is large and swollen, red and moist, due to lack of nerve endings to it does not hurt to touch. During the week, it decreases and reaches its final size after 2 months. The stoma may bleed when touched, but this is normal and not a cause for concern.
In some cases, the loop is used to lock the rod until it heals. A few days later it is removed.
Loop colostomy usually is a timing procedure that is used to treat conditions such as diverticulitis, Crohn's disease and intestinal cancer.
End colostomy in Assuta
For the formation of a stoma one end of the large intestine sutured to the skin. As with loop colostomy, location hole depends on what body segment is removed. Basically, the stoma is placed on the left side of the abdomen, below the belt line. This issue is discussed before the operation.
The stoma will have one aperture through which faeces are located. The other end of the large intestine, leading to the rectum, be sealed and left inside the abdomen.
End colostomy is often permanent. As the time they are created for emergency assistance in the treatment of intestinal obstruction, intestinal injury or cancer.
An alternative in some cases it may be ileostomy. It is formed in the same manner, but do not use the colon and thin.
Sometimes ileostomy is more preferable because it can be created by internal Colostomy bags connected to the anus. Thus, bowel actions are controlled in the usual way.