Sleeve colostomy in the surgical treatment of patients with acute obstructive colon obstruction

Objective. To improve the results of surgical treatment of patients with acute obstructive colon obstruction, which consists of performing emergency colostomy, by introducing new methods for the prevention of early and late purulent–septic paracolostomy complications. Materials and methods. Purulent–septic paracolostomy complications were analyzed in 85 patients operated on for acute obstructive colonic obstruction, in whom urgent colostomy was performed: in 33 patients (group 1), a colostomy was created using the standard technique with the application of a colostomy bag immediately after surgery; in 52 patients (group 2), a sleeve colostomy was created using the proposed technique with delayed application of a colostomy bag. There were 15 patients aged 40 to 59 years, 58 aged 60 to 74 years, and 12 older than 75 years. All patients were diagnosed with one or more somatic diseases in the stage of compensation or subcompensation. Both groups were comparable in terms of age, concomitant pathology, and the degree of acute obstructive colonic obstruction. Results Thanks to the use of the proposed sleeve colostomy in the surgical treatment of acute obstructive colonic obstruction, the frequency of postoperative purulent–septic paracolostomy complications decreased from 27.2 to 3.8%, paracolostomy dermatitis from 33.3 to 13.4%, postoperative mortality from 9.1 to 3.8%, and the duration of inpatient treatment from (21 ± 3) to (11 ± 2) days. Conclusions. Prevention of colostomy wound infection by draining intestinal contents through a sleeve–drain outside the surgical field, bypassing skin–intestinal sutures, improved wound healing and surgical outcomes in patients with acute obstructive colonic obstruction.