| Journal: |
The Egyptian Journal of Surgery
Elsevier
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Volume: |
39
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| Abstract: |
Introduction
One distinct disadvantage of Paul Mikulicz double-barreled colostomy is the need to
apply an enterotome to the stoma for several days to crush the intervening spur
before the double-barreled colostomy is closed. A new modification of the old
technique was applied to omit the usage of the enterotome and avoid the riskiest
complications of colostomy closure.
Aim
The aim of this study was to evaluate the efficacy and safety of this new technique,
staged stapling closure of the double-barreled stomas, to publicize its use for all
temporary stomas.
Patients and methods
Being a new technique, only 20 patients were included in this study. They all were
old patients of both sexes. This new technique is accomplished in three stages:
stage I is to perform the original double-barreled enterostomy in its native manner,
stage II: 1 week later after in the outpatient clinic without the need for anesthesia,
sterilization, or bowel preparation, where the spur between the two limbs of the
enterostomy is divided using GIA stapler, and stage III: where 2 weeks later, under
local or spinal anesthesia, extraperitoneal closure of the stoma was done with
double-layer sutures.
Results
This study was carried out between November 2018 and January 2020 on 20
patients, aged 64–86 years, comprising 12 males and eight females. Only one (5/
%) case was complicated with leakage and wound gaping. She had another trial of
closure 2 weeks later, which succeeded. At the end, all patients were discharged
home, with open bowel, normal defecation, and surgically stable. There was no
mortality throughout our study.
Conclusion
Extraperitoneal staged stapling closure of the double-barreled enterostomy is a
safe and easy technique to close temporary stomas with no need for another
laparotomy and without the risk of peritonitis or obstruction.
Keywords:
double-barreled stoma, GIA stapler, staged closure
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