Complications of colostomy in colorectal carcinoma

By | January 1, 2012

In recent years, the incidence of colorectal cancer rate in China has increased year after year, to master the law of development of colorectal cancer diagnosis and prognosis are important ways. Based on years of clinical treatment of colorectal cancer found that patients with colostomy affect daily life, which may lead to complications of colostomy in colorectal cancer are the following:
(1), stoma retraction: dual-chamber easily retracted stoma, but there is support rod intestinal loop stable, and there is temporary, so the consequences of not very serious, single-chamber permanent stoma is not, and if the retraction to flush skin, will cause serious inconvenience to the patient. Prevention of stoma retraction is not difficult, the most important is the sigmoid colon, descending colon stump in particular, to fully free, splenic flexure of parts should be loose, to ensure that no tension, but also pay attention to the integrity of the bow and the stump of vascular blood for obese patients with fatty mesangial, mesangial shortening, particular attention should be. Bowel and peritoneal stump side of the gap to be the number of needle stitched closed, can prevent the occurrence of internal hernia, colon stump can also be fixed to help prevent stoma retraction. Intestinal muscle should be sutured in pulp stoma skin. Stump pulled out to a sufficient length of time in vitro, but not too long, immediately open the stump, the suture after mucous membrane flip length less than 2 cm, the temporary incarceration of the stump. At least 4 should be retained cm.
(2) making stenosis: is the more common complications. Bowel function recovery of patients immediately after defecation difficulties arise, because the abdominal wall stoma multi-channel narrow, too tight. Stoma at the skin and the corresponding rectus sheath should be cut out a small piece of the former, stoma diameter of about 2 cm circular defect, such as the rectus abdominis more developed, it should be removed a small, perfect to stop bleeding. Narrow the late, multi-channel because of chronic abdominal infection, due to granulation formation and scar contracture. In the production channel, can be peritoneal slit in the skin, serosa of the channel. Bowel wrapping around the pipe will not be fiber can reduce the chance of stenosis. Stoma opening, with particular attention to early care and cleaning, to avoid colostomy Channel infection. Stump due to intestinal stoma ischemia, necrosis can also lead to stenosis. In the event of a narrow, finger expansion stoma available, depending on the circumstances, daily or every few days to ask the expansion time, refers to the accommodation shown. Such as severe stenosis, the expansion is not valid, you need to remove stoma, in situ re-create a new stoma.
(3) complications of colon cancer in the colostomy stoma prolapse: intestinal stoma prolapse side gradually becomes tedious, extrusion can grow to 20 cm above may also occur after a sudden increase in abdominal pressure, prolapse of the bowel mucosa and easy damaged Erzhi ulcers. Production of stoma, the abdominal wall channel should not be too large, to accommodate two-finger right through to, need to pay attention to intermittent bowel stoma suture side in the peritoneum and abdominal skin. In severe cases required surgical treatment, prolapse of the bowel fixation.
(4), stoma necrosis: a serious complication. Stump due to intestinal blood flow did not pay attention, injuries and peripheral blood vessels supplying the arch vessels, out of the Department of intestinal membrane tension after the end too large or too small channel abdominal wall can also affect the blood supply. If you do take note when the stoma, out of the side after the close observation of intestinal blood flow, timely adjustments can be avoided. If avascular necrosis occurs after surgery. Occurred in the mesenteric edge of the opposite side, mostly mucosal necrosis, such as the more limitations, can be observed for some time after the necrosis and often self-healing membrane off, such as necrosis deep to the muscle, probably secondary to narrow, to be expanded or further surgery. Such as extensive necrosis, and even affect membrane cavity, need immediate surgery, ischemic bowel resection, the production of a new stoma.
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