Sigmoid colostomy

Sigmoid colostomy is to move the proximal segment of the sigmoid colon to the left lower abdominal wall to form a single-mouth ostomy. Often used as a permanent artificial anus, but also as a temporary artificial anus. Treatment of diseases: anal canal cancer, rectal cancer Indication 1. Rectal or anal canal cancer after resection of rectal cancer or anal canal cancer, for permanent artificial anus. 2. Traumatic rectal rupture, for temporary artificial anus (usually with sigmoid colon fistula). 3. For infection, stenosis and obstruction of the rectum. Surgical procedure 1. Position: supine position. 2. Incision: Right incision in the left lower abdomen; or oblique incision in the left lower abdomen, similar to the appendix incision on the right side, about 5 to 7 cm long. 3. Cut off the sigmoid colon: Select the sigmoid colon ostomy, generally take the sigmoid colon with a greater degree of mobility, about 10 ~ 15cm away from the tumor. Separate the sigmoid mesentery from the side of the intestine to the root of the mesentery. Be careful not to damage the mesenteric vessels and ligature the bleeding. Use two duodenal forceps or a full-toothed hemostat to clamp the sigmoid colon of the isolated mesentery and cut the sigmoid colon between the two forceps. The proximal sigmoid colon is sheathed with a condom and ligated with gauze strips. 4. Closed distal sigmoid colon: In the first rectal resection, the distal sigmoid colon is also covered with a condom, the gauze strip is ligated, and then removed with the tumor. In the case of staged rectal resection, the inner layer of the distal sigmoid colon was sutured in a full layer with a 1-0 silk thread, and the outer layer was sutured with a thin silk thread as a sarcolemma, which was then delivered into the pelvic cavity. 5. Proximal sigmoid ostomy: generally in the left lower rectus abdominis, 6cm below the umbilicus, as a fusiform or oblique small incision, remove a piece of skin and external oblique aponeurosis, use the finger to explore the size of the incision, need to be suitable The proximal sigmoid colon passes. Immediately after the proximal sigmoid colon is taken out from the small incision, the gap between the incision and the intestinal wall is probed with a finger to accommodate a finger. The proximal sigmoid colon was taken out 5 cm outside the incision, and the proximal sigmoid mesenteric membrane in the abdominal cavity and the peritoneum of the left abdominal wall were sutured with a thin wire, and the condom and gauze strips of the stump were not unwound. The ostomy and the efferent sigmoid colon are protected by a Vaseline gauze wrap. 6. Stitching: suture the abdominal wall incision layer by layer.

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