[Definite colostomy using a circular stapler: a technique to be reconsidered].
Personal experience on a particular utilization of circular stapler is reported. At the beginning the fast and easy execution emphasized its use. However, the constant appearance of a late complication was observed, i.e. the progressive stenosis of the stoma. This event occurred even when maximal size of the instrument was used and it reappeared after repeated procedures of instrumental or surgical dilatation. The effective validity of this technique was evaluated by the Authors. On the other hand, the Burk alternative technique, with a second purse-string on the cutaneous ring seems to prevent the stenosis. However, it is slow and difficult as traditional procedure. The causes of the neostoma stenosis performed by circular stapler, reported by the Authors in 100% of cases, are easily explained with the absence of biological barrier of colonic mucosa that normally prevents excessive tissue growth.
Marini
P
P
Divisione di Chirurgia Generale, Ospedale C. Forlanini, Roma.
Paganelli
L
L
Sorgi
G
G
Gucciardo
G
G
Nesta
M
M
Campanelli
A
A
Carboni
R
R
D003125:Colostomy / Q000009:adverse effects / Q000379:methods*; D003251:Constriction, Pathologic; D005069:Evaluation Studies as Topic; D006801:Humans; D012008:Recurrence; D013528:Surgical Staplers
La colostomia definitiva mediante stapler circolare: una tecnica da riconsiderare.