[Pseudo-continent perineal colostomy. Results and techniques]

J Chir (Paris). 1997 Sep;134(4):174-9.
[Article in French]

Abstract

Objective: This prospective study was conducted to assess functional results obtained after pseudo-continent perineal colostomy using the Schmidt procedure.

Methods: Functional outcome was assessed in 40 patients who had undergone amputation of the rectum for cancer and pseudo-continent perineal colostomy reconstruction between 1989 and 1995 in our institution. The cancer pathology, operative procedure and post-operative care were noted. Morbidity, functional outcome and degree of patient satisfaction were recorded. Mean follow-up was 45 months (18-87) in 100% of the patients.

Results: There were no operative deaths. Twenty patients had post-operative complications and 2 patients required early conversion to definitive abdominal colostomy due to severe perineal complications. Function outcome showed normal continence in 4 patients, air incontinence in 23, occasional minimal leakage in 9 and incontinence requiring iliac colostomy in 2. Eighty-six percent of the patients were highly satisfied or satisfied with their continence capacity.

Discussion: Pseudo-continent perineal colostomy is a reliable technique which can be proposed as an alternative to left iliac colostomy after amputation of the rectum for cancer if a rigorous procedure is applied: careful patient selection, informed consent, rigorous surgical procedure, daily life-long irrigation of the colon.

Publication types

  • English Abstract

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Amputation, Surgical
  • Anal Canal / surgery
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Colostomy / methods*
  • Fecal Incontinence / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / pathology
  • Melanoma / surgery*
  • Middle Aged
  • Perineum / surgery
  • Prospective Studies
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Surgically-Created Structures / physiology