SIGMOIDOSTOMY (Latin intestinum sigmoideum a sigmoid gut + Greek stoma of companies, an opening, pass) — operation of imposing of fistula on a sigmoid gut — sigmostoma.
Distinguish pristenochny (incomplete), single-barreled and divided double-barrel sigmostoma; two last represent full intestinal fistulas (see).
Indications and Contraindications
Indications: acute impassability of distal departments of a large intestine when unloading of intestines is necessary (with simultaneous elimination of the reason of impassability or as the first stage of treatment of the last); heavy inflammatory processes in a direct and sigmoid gut, napr, at a disease Krone, the divertuculosis complicated by a diverticulitis and perforation of diverticulums (for the purpose of temporary or constant shutdown of a passage on the struck departments); reconstructive and recovery operations on bodies of a small pelvis and in a crotch.
Contraindications: the expressed inflammatory defeat of a wall of a sigmoid gut at nonspecific ulcer colitis, the complicated divertuculosis and other diseases. In these cases at the corresponding indications carry out a transverzostomiya.
Classical option of imposing of a sigmostoma provides a podshivaniye of edges of a peritoneum to edges of a skin wound with the subsequent fixing by the same seams of a wall of the removed sigmoid gut. In this case the wall of a gut is opened in 1 — 2 days. At a considerable part of patients process of healing is followed by cicatricial deformation and even narrowing of a sigmostoma that complicates bowel emptying.
The technique of imposing of a so-called flat sigmostoma (at the level of skin) with a podshivaniye of edges of a peritoneum to a serous cover of a gut and the subsequent sewing together of edges of the opened gut with edge of a skin wound gains distribution. At such technique of edge of a skin wound and an intestinal wall heal first intention, maturing of an ostomy goes quicker and usually is not followed by its cicatricial narrowing.
A calla and gases nek-ry surgeons apply to ensuring function of deduction at S. implantation of magnetic rings with the subsequent introduction to an ostomy of special locks.
S.'s complications — perikolostomichesky abscesses, peritonitis, perikolostomichesky hernias, etc. — meet seldom.
Bibliography: Kiene S. Single-step colostomy, Surgery, No. 12, page 33, 1975; Cancer of a rectum, under the editorship of V. D. Fedorov, M., 1979; With N e sh to about L. I. and T about-puzov E. G. O to technology of imposing of an unnatural anus at an extirpation of a rectum, Vestn. hir., t. 103, No. 11, page 41, 1969; In and with about n H. E. Cancer of the colon, rectum and anal canal, Philadelphia — Montreal, 1964.
V. D. Fedorov.