title: Endoscopic colostomy with percutaneous colopexy: an animal feasibility study.
abstract: BACKGROUND
  Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia.
  
  
  OBJECTIVE
  To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy.
  
  
  METHODS
  Five pigs underwent endoscopic assisted colostomy with percutaneous colopexy. Animals were evaluated in post-operative days 1, 2, 5 and 7 for feeding acceptance and colostomy characteristics. On day 7 full colonoscopy was performed on animals followed by exploratory laparotomy.
  
  
  RESULTS
  Average procedure time was 27 minutes (21-54 min). Postoperative mobility and feeding of animals were immediate after anesthesia recovery. Position of the colostomy, edges color, appearance of periostomal area, as well as its function was satisfactory in four animals. Retraction of colostomy was present in one pig. The colonoscopy and laparotomy control on the seventh day were considered as normal. A bladder perforation that was successfully repaired through the colostomy incision occurred in one pig. The main limitation of this study is its experimental nature.
  
  
  CONCLUSIONS
  Endoscopic assisted colostomy with percutaneous colopexy proves to be a safe and effective method with low morbidity for performing colostomy in experimental animals, with possible clinical application in humans.
authors.affiliation: Coloproctologia, Hospital das Clinicas Facultad de Medicina USP, Brasil.
authors.forename: Leonardo Alfonso
authors.initials: LA
authors.lastname: Bustamante-Lopez
authors.affiliation: Gastroenterology, endoscopic division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Marianny
authors.initials: M
authors.lastname: Sulbaran
authors.affiliation: Gastroenterology, surgical division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Sergio Carlos
authors.initials: SC
authors.lastname: Nahas
authors.affiliation: Gastroenterology, endoscopic division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Eduardo Guimaraes Horneaux
authors.initials: EG
authors.lastname: de Moura
authors.affiliation: Gastroenterology, surgical division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Caio Sergio
authors.initials: CS
authors.lastname: Nahas
authors.affiliation: Gastroenterology, surgical division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Carlos Frederico
authors.initials: CF
authors.lastname: Marques
authors.affiliation: Gastroenterology, endoscopic division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Christiano
authors.initials: C
authors.lastname: Sakai
authors.affiliation: Gastroenterology, surgical division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
authors.affiliation: Gastroenterology, endoscopic division, University of Sao Paulo, Medical school, Brasil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
mesh_terms: D000818:Animals; D003125:Colostomy / Q000009:adverse effects / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D011184:Postoperative Period; D034421:Sus scrofa; D013552:Swine