title: Perineal colostomy: an alternative to avoid permanent abdominal colostomy: operative technique, results and reflection.
abstract: BACKGROUND
  The most common injury to indicate definitive stoma is rectal cancer. Despite advances in surgical treatment, the abdominoperineal resection is still the most effective operation in radical treatment of malignancies of the distal rectum invading the sphincter and anal canal. Even with all the effort that surgeons have to preserve anal sphincters, abdominoperineal amputation is still indicated, and a definitive abdominal colostomy is necessary. This surgery requires patients to live with a definitive abdominal colostomy, which is a condition that modify body image, is not without morbidity and has great impact on the quality of life.
  
  
  OBJECTIVE
  To evaluate the technique of abdominoperineal amputation with perineal colostomy with irrigation as an alternative to permanent abdominal colostomy.
  
  
  METHODS
  Retrospective analysis of medical records of 55 patients underwent abdominoperineal resection of the rectum with perineal colostomy in the period 1989-2010.
  
  
  RESULTS
  The mean age was 58 years, 40 % men and 60 % women. In 94.5% of patients the indication for surgery was for cancer of the rectum. In some patients were made three valves, other two valves and in the remaining no valve at all. Complications were: mucosal prolapse, necrosis of the lowered segment and stenosis.
  
  
  CONCLUSIONS
  The abdominoperineal amputation with perineal colostomy is a good therapeutic option in the armamentarium of the surgical treatment of rectal cancer.
authors: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors: Alcino Lázaro
authors: AL
authors: da Silva
authors: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors: Johnny
authors: J
authors: Hayck
authors: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors: Beatriz
authors: B
authors: Deoti
mesh_terms: D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy / Q000379:methods*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
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