الفهرس 
Title : An innovative technique for perineal colostomy after abomino-perineal resection for carcinoma of the rectum: Towards a better quality of life
ContentsOnly 14 pages are availabe for public view
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Abstract
Background: apr is still a procedure of choice in the management of rectal cancer. a left iliac permanent colostomy has a great impact on the QOL of the patients. Many procedures and techniques have been introduced for the creation of a perineal colostomy aiming at improving the QOL of these patients. objective: This work is a scientific practical contribution to improve the quality of life of patients after abdomino-perineal resection for carcinoma of the rectum. To achieve this, the aim of this study is to evaluate an innovative unprecedented technique for a continent perineal colostomy instead of the left iliac colostomy. patients and methods: A prospective observational study including 20 patients with low rectal cancer treated surgically with APR followed by a perineal colostomy using an innovative technique of a CSMC. An immediate (Synchronous) reconstruction after APR was done in14. In 6 patients the operation as a delayed (Metachronous) step 2-4 years after APR. Patients were subjectively and objectively evaluated. Kirwan’s scoring system was used for subjective assessment. The Endo-FLIP was used for objective assessment. results: Thirteen patients (72%) were continent; 2 normal continence for gas and stool and 11 patients were continent only for stool. Four patients had minor soiling. Seventeen patients (94.5%) were satisfied. Only one patient suffered incontinence. The objective results showed a mean segment length of 5.3 cm. The mean diameter of the neo-sphincter was 13.8 & 9.8 mm at rest and on squeezing respectively. On cough, the mean diameter was 11.2 mm at the segment level versus 22.1 mm at the proximal colonic segment. Patients were able to evacuate the catheter with a mean of 3.2 seconds