colostomy closure

Colostomy closure is suitable for temporary transverse colostomy, the patient's condition is improved, the intestine at the distal end of the stoma is unobstructed, and the stoma can be closed. Generally, it is appropriate to close it about 3 months after the ostomy. Treating diseases: colon fistula Indication Colostomy closure is suitable for temporary transverse colostomy, the patient's condition is improved, the intestine at the distal end of the stoma is unobstructed, and the stoma can be closed. Generally, it is appropriate to close it about 3 months after the ostomy. Contraindications Those who have obstruction at the distal end of the stoma should not be closed. Surgical procedure 1. Around the colostomy, make a fusiform incision close to the mucosa, cut the skin and subcutaneous tissue, and separate the colon. Use scissors to cut off the edges of the mucous membranes and the skin and scar tissue attached to them. 2. Use a 3-0 chrome gut to make a full-line continuous inversion suture and close the stoma. 3. Use a thin non-absorbent line to make a row of sarcoplasmic sutures. The surgeon then replaces the gloves, resterilizes the surgical field skin, replaces the surgical towel and all contaminated equipment. 4. Continue to separate the adhesion of the colon to the abdominal wall, directly to the abdominal cavity, completely separate the intestinal tube from the abdominal wall, and then return the intestinal segment to the abdominal cavity. 5. After suturing the peritoneum with the No. 1 chrome gut, the wound was washed with saline, and the abdominal wall incision was sutured by suture. The rubber sheath was placed under the anterior sheath of the rectus abdominis and drained from the incision. complication 1. Anastomotic fistula, if the suture technique is perfect, it is caused by excessive flatulence or mesenteric vascular ligation. The former and intestinal paralysis exist simultaneously, not easy to detect; the latter clinical manifestations are clear, mainly for the performance of advanced peritonitis. If the abdominal inflammation is obvious and the scope is wide, open drainage should be performed; if the inflammation is limited, a few needles can be removed from the incision suture, placed in the drainage, and treated with non-surgical treatment. 2. The anastomotic stenosis is mild and narrow, and no special treatment is needed. Due to the expansion of feces, most of them can be relieved by themselves. Severe stenosis requires surgery.