transverse colostomy

Transverse colostomy is a temporary partial ostomy. In a few cases, it can be used as a permanent artificial anus. Treatment of diseases: chronic ulcerative colitis colon cancer Indication 1. Acute obstruction of the left colon, can not be eradicated, can be used for temporary decompression of transverse colon fistula. 2. Left colon cancer complicated with acute obstruction, temporary decompression, or advanced case as permanent artificial anus. 3. The left side of the colon is traumatic rupture, or the colon and rectum anastomosis can be temporarily decompressed to ensure healing. 4. Ulcerative colitis, the lesion is limited to the left colon, the transverse colon fistula causes the feces to divert and relieve the stimulation of the lesion. 5. Colon, including the first surgery of rectal resection. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Most patients are in poor condition and must be fully prepared before surgery. 1. Infusion, blood transfusion, correction of dehydration, acidosis and low plasma protein. 2. Intramuscular injection of vitamins b1, c, k. 3. Actively control infection and rational use of antibiotics. 4. Patients with intestinal obstruction or stomach or duodenal fistula should be placed with gastrointestinal decompression tube before operation. Surgical procedure 1. Position: supine position. 2. Incision: right upper transabdominal rectus incision or right upper quadrant transverse incision. 3. Exposing the transverse colon: After cutting the peritoneum, an incision is made in the transverse colon. Sometimes due to obstruction. The proximal colon is extremely enlarged. The mesenteric membrane becomes shorter, and the intestinal fistula is relatively fixed, which is difficult to propose. In this case, the gas in the colon can be aspirated by a thick needle connected to the aspirator to cause it to collapse. With the saline gauze pad enveloping, the omentum of the transverse part of the external part is determined to be separated, and the bleeding point is ligated, and the omentum is then returned to the abdominal cavity. 4. Fix the external colon: Cut a small mouth in the avascular area of the external transverse mesenteric membrane, and pass through a short glass rod. The two ends of the glass rod are fixed with a piece of rubber tube to prevent the intestinal tube from retracting into the abdominal cavity. 5. Stitching the abdominal wall: If the incision is too large, the abdominal wall can be sutured layer by layer. The fat of the external intestine is sutured to the peritoneum. The peritoneum and fascia were sutured intermittently with a medium-sized silk thread, and the skin was sutured intermittently with a thin thread. Finally, use your fingers to probe the tightness of the incision. Generally, the gap between the incision and the intestinal wall is suitable for one finger. 6. Treatment of external intestinal fistula: If the colon is heavier and heavier, it needs immediate decompression. A small mouth can be cut in the external intestine, a fistula catheter is placed in the proximal end, and the filament is sutured and sealed, and the outer end of the catheter is connected and drained. bottle. Finally, wrap the surrounding intestinal and intestinal walls with Vaseline gauze and pad the glass rods. complication Abdominal infection.

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