一時的人工肛門の閉鎖時期に苦慮した1例

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  • A DIFFICULT CASE OF DECIDING AN OPPORTUNITY OF TEMPORAL COLOSTOMY CLOSURE

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The case involved a middle-sized 61-year-old man. Temporal transverse colostomy was made because of anastomotic leakage with pan-peritonitis 7 days after a low anterior resection for a lower third rectal cancer using double stapling technique. After 4 months and 22 days, a stoma closure operation was done, but re-leakage occurred at the old anastomotic site. We had to make another temporal colostomy at the ascending colon. Before closure operation for the second colostomy, we defined the status of healing of the old anastomotic leakage by some tests such as pressure test, defecation and flatus test. Thereafter a stoma closure operation was carried out 1 year and 4 months after the temporal ascending colostomy. The following course was uneventful. When we plan to close the temporal colostomy made emergently for anastomotic leakage after low anterior resection, we should decide the appropriate time for the closure, after making sufficient arrangements including background factors and the degree of the leakage, healing status of the anastomotic site, and a possible re-leakage.

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