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The Extraperitoneal Flat Artificial Colostomy—with 1840 Cases Report

WANG Hui,WANG Ren hua,WANG Bin,et al. (Liaoning Provincial Tumor Hospital,Shen yang 110042,China)  
urpose〕To approach the procedure of the extraperitoneal flat artificial colostomy.〔Methods〕One thousand eight hundred and forty cases with carcinoma of rectum and anal canal underwent extraperitoneal flat artificial colostomy after abdominal peri to neal resection of carcinoma. The main points of the operation:1.To draw a line from umbilicus to left anterior superior iliaca spine at first,and then the site of colostomy was at the point of intersection between the oblique line and lateral edge of rectus,which paralleled to umbilicus, did not avoid belt. 2. The diameter of orifice of the colostomy was about 2.5 to 3.0cm,the same as that of orifice of colon.3.To make a tunnel extraperitoneally through anterior sheath of lateral edge of rectus,rectus and posterior sheath of rectus. 4.To pull the colon out through the tunnel and sutured the end of bowel in all layers with dermis of skin interruptedly.The orifice of the colostomy was at the same horizontal line of skin after finishing the colostomy.Close the space between the colon and lateral peritoneum.〔Results〕The succeseful rate of the new operation was 92.08%,and the complication rate,7.92%.〔Conclusion〕The advantages of the new type of operation ,compared with traditional colostomy,are as follows:The operation is simple and time saving.No parastomal pain and bleeding caused by crushing and rubbing were founded.The stenosis,invagination and prolapse do not occur.It is suitable for collecting feces and applying bags,which does not influence the patients' clothing and pleasing to the eyes.Patients can work and join physical exercises with belt on the stoma.We think that the extraperitoneal flat artificial colostomy is quite an ideal operation.
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