Colostomy

1. When do cancer patients have a colostomy?
2. How to perform the operation?
3. Recommendations to the patient after colostomy
4. Nutrition after colostomy
5. Colostomy care
6. Possible complications in a patient with colostomy

A colostomy is a surgical procedure during which a section of the colon is brought out through a hole in the abdominal wall and a colostomy is formed - a hole for the discharge of feces, mucus and gases. This operation is carried out in various diseases of the colon and rectum. Often it is necessary to resort to it in cancer patients.

The colon is a part of the large intestine. It absorbs water and certain nutrients, forms fecal masses, which then enter the sigmoid, rectum, and are evacuated to the outside through the anus (anus).

In violation of the function of the colon, rectum and anus, the evacuation of fecal masses becomes very difficult or even impossible. It is this problem that solves the colostomy. The surgeon creates an artificial hole that temporarily or permanently takes over the functions of the anus.

When do cancer patients have a colostomy?

Indications for colostomy in cancer:

• Surgeries during which the rectum is completely removed by the tumor.
• Surgeries during which the colon is removed, but due to the high risk of complications (peritonitis, cutting through the sutures), the ends of the intestine cannot be sutured.
• The inability to remove a tumor of the intestine due to the serious condition of the patient or other reasons. In this case, the colostomy is performed as a palliative surgery.
• The operation, during which the tumor of the intestine was removed, but the surgeon is not sure about the reliability of the stitches.
• Complications of colon and rectal cancer: germination in neighboring organs, the formation of fistulas, the development of purulent inflammatory process.
• Development of a severe inflammatory process in the rectum after a course of radiation therapy for malignant pelvic tumors.

How to perform the operation?

A colostomy is performed under general anesthesia in the operating room, open way or laparoscopically. Depending on the state of the intestine, either the two ends of the gut can be hemmed into the skin, or only one. Accordingly, the colostomy can be double-barreled or single-barreled.

The surgeon chooses the place where the colostomy will be removed, depending on the location of the intestinal lesion, the degree of development of the patient's fatty tissue, skin condition (it is very difficult for the colostomy to take out where the scar is located).

After applying a colostomy to collect fecal masses attach a special plastic bag - calopriemnik. It is attached to the skin with an adhesive backing. Sometimes the glue is applied directly to the bag for collecting feces, and sometimes - on a special separate plate, which is twisted on the neck of the container, as the cap on the bottle. There are still cathopoles that are mounted on a special belt, but they are not very convenient, therefore, they are rarely used at present. Modern kalopriemniki are quite convenient, they practically do not interfere with daily life and work, but require regular maintenance and replacement. The nature of the feces will depend on the level at which the intestine is drawn onto the skin. If a large part of the intestine is left, they are practically the same as normal.

Recommendations to the patient after colostomy

Before you start taking any medication, be sure to consult a doctor. Some drugs can cause constipation or diarrhea. If you are being treated for other diseases, be sure to tell your doctor that you have applied a colostomy. Follow the diet recommended by an oncologist. If necessary, contact your nutritionist - he will create for you a diet that will help you to avoid constipation, diarrhea and increased gas formation.

Carry out daily thorough care of the colostomy, regularly change the catheter. This will help avoid complications. Try to live the fullest possible life, as far as the underlying disease allows. A colostomy causes psychological discomfort in many patients, especially at first, but it is imperceptible under clothing and practically does not interfere with household chores and work.

Nutrition after colostomy

Return to a normal diet after the operation occurs gradually:

• It is forbidden to eat and drink during the first day, you can only wet your lips with water or hold a small piece of ice in your mouth for a while;
• the day is usually allowed to drink water;
• on the second day after the operation, the patient is gradually given liquid and soft food.

Human nutrition after colostomy is different from healthy nutrition. The main objectives - to prevent constipation and diarrhea, increased gas formation. General recommendations before discharge from the hospital will give an oncologist. In the future, you can contact a nutritionist.

It is desirable to eat 4–5 times a day at about the same time, without missing a single meal. It is necessary to chew slowly, carefully. It is necessary to avoid eating large amounts of foods that have fixative and laxative effects that cause increased gas formation.

Colostomy care

The capstan needs to be changed as it is filled. If you do not make a change in time, it will overflow and peel off itself. This can lead to great inconvenience.
During each replacement of the colostomy compartment, the skin around the colostomy should be thoroughly washed with warm water and soap, the hair should be shaved and the remnants of the glue base should be removed. On the adhesive layer, a hole is cut out, the diameter of which should be 3–4 mm larger than the colostomy size. Then remove the protective film and stick the colostomy bag to the skin, from the bottom up. Unstick it in the opposite direction - from top to bottom.
Before discharge from the hospital, the patient and his relatives will be taught how to independently care for the colostomy, to change the colostomy container.

Possible complications in a patient with colostomy

As a result of constant contact with the contents of the intestine and the adhesive base of the calophorium, irritation, redness, itching, pain, rashes can occur on the skin around the colostomy. For the prevention and control of this complication use special protective creams and powders.

Other possible complications:

• Suppuration of tissues around colostomy. It is manifested by pain, fever, redness of the skin.
• The death of the intestine, derived on the wall of the abdomen. It changes color, turns black, there is severe pain, the discharge of feces is disturbed.
• Hernia. This complication can occur after any operation in which an incision is made in the abdominal wall.
• Prolapse of the intestine. In this case, it may occur infringement and death.
• Scarring and narrowing of the intestinal lumen. Stool does not move away for a long time, pain and discomfort in the abdomen.

If you experience any of the symptoms described above, you should immediately consult a doctor.

Even if a colostomy is performed with a palliative purpose, it can greatly alleviate the suffering and prolong the life of the cancer patient. In the European clinic, the imposition of colostomy and other operations for cancer of the colon and rectum performed by experienced surgeons. We adhere to European standards, use modern techniques, and this helps us to improve the results of treatment, the prognosis for our patients.

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