[Pseudo-continent perineal colostomy. Results and techniques].
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.


CONCLUSIONS
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.
Lasser
P
P
Département de Chirurgie, Institut Gustave-Roussy, Villejuif.
Dubé
P
P
Guillot
J M
JM
Elias
D
D
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000671:Amputation, Surgical; D001003:Anal Canal / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003125:Colostomy / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D019738:Surgically-Created Structures / Q000502:physiology
Colostomie périnéale pseudo-continente. Résultats et technique.