Subjective Assessment of an Innovative Technique for Perineal Colostomy after Abdomino-Perineal Resection for Carcinoma of the Rectum: Towards a Better Quality of Life

MOUNIR ABOUL ELA, M.D., MAMDOUH MOUNIR, M.Sc.;; GAMAL AMIRA, M.D., MOHAMED GAMIL, M.D.;; TAREK KHAIRY, M.D., AHMED FARAG, M.D.;

doi:10.21608/mjcu.2019.69911

Subjective Assessment of an Innovative Technique for Perineal Colostomy after Abdomino-Perineal Resection for Carcinoma of the Rectum: Towards a Better Quality of Life

Document Type : Original Article

Authors

The Department of Surgical Oncology, National Cancer Institute, Cairo University

10.21608/mjcu.2019.69911

Abstract

Abstract
Background: Abdomino-perineal resection is still a pro-cedure of choice in the management of rectal cancer. A left iliac permanent colostomy has a great impact on the quality of life of the patients. Many procedures and techniques have been introduced for the creation of a perineal colostomy aiming at improving the QOL of these patients.
Aim of Study: This work is a scientific practical contribu-tion to improve the quality of life of patients after APR for carcinoma of the rectum. To achieve this, a subjective evalu-ation of an innovative unprecedented technique for a continent perineal colostomy instead of the left iliac colostomy was done.
Material and Methods: A prospective observational study included 20 patients with low rectal cancer treated surgically with APR followed by a perineal colostomy using an innovative technique of a circular smooth muscle cuff. An immediate (Synchronous) reconstruction after APR was done in 14. In 6 patients the operation as a delayed (Metachronous) step 2- 4 years after APR. Patients were subjectively evaluated using Kirwan's scoring system.
Results: Thirteen patients (72%) were continent; 2 normal continence for gas and stool and 11 patients were continent only for stool. Four patients had minor soiling. Seventeen patients (94.5%) were satisfied. Only one patient suffered incontinence.
Conclusion: This new technique proved to be valuable in improving the QOL of patients with rectal cancer after APR. The procedure achieved 94% patient satisfaction.

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