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Many patients look forward to the operation to close the colostomy, because then the person has the opportunity to live a normal life again and cope with his needs with the help of the anus, which is not located on the stomach, but in the right place. But from the closure of the colostomy to the normalization of the processes of stool output, a long rehabilitation period will have to go through, to establish the functionality of the large intestine.
What to expect from such an operation and when the recovery period ends can be found in the article below.
How is colostomy surgery performed?
A colostomy is an artificially created opening in the large intestine that facilitates the expulsion of feces to the outside. It is applied in various cases: with problems with the lower intestines, with malignant neoplasms and other factors. A colostomy can be either temporary or permanent.
The operation to close a temporary colostomy is called a reconstructive-restorative operation and is the elimination of a previously imposed stoma.
The operation is carried out by a qualified and experienced surgeon and proceeds within one hundred to one hundred and twenty minutes. In some cases, the duration of the operation reached three hours. Sometimes the elimination of the colostomy occurs in two stages, the interval between which is several days. Such an operation is performed under general anesthesia, and if the patient’s heart is not able to cope with general anesthesia, then the colostomy is not closed until his heart can cope with such a load.
This method of surgical intervention consists of several stages.
If a double-barrel stoma was imposed, then an incision is made between the holes, with a previously imposed single-barrel colostomy, the length of the incision directly depends on the longitudinal incision of the colon.
After the incision, the section of the intestine on which the stoma was performed is taken out.
With a single-barrel colostomy, the two ends of the intestine are connected, and with a double-barrel, the holes are simply sewn up. The terminal stoma, when closed, is most often accompanied by the removal of that part of the intestine that was cut longitudinally. It turns out that the intestines in any case will not function as before. The most striking consequence of this is a rapid bowel movement, the time of which is from fifteen minutes to two hours from the moment of eating. Therefore, to increase the digestibility of products, you need to eat several times more, but for this purpose, the method of fractional nutrition is most often used. That is, they eat often, but in small portions. Thus, the operation to close a double-barrel stoma is easier for both the patient and the surgeon who performs it than the closure of a terminal stoma with a single opening.
Then the muscle tissues are sutured, and after that, upper sutures are applied using self-absorbable threads. The last step is to check the intestines for tightness. Such an operation may contain additional steps, when required, for example, transplantation of the rectal lobe.
Contraindications and possible complications when closing a colostomy
To restore the work of the intestine at the previous level is obtained only in forty percent of all cases. After such an operation, some complications are possible that affect both the area where the colostomy was previously applied, and the work of the intestine, which has not functioned for a long period of time. The most severe complications occur after the elimination of the terminal single-barrel colostomy, since such a stoma is considered permanent and is placed for the rest of your life.
When closing any type of colostomy, the following complications occur:
- prolapse of the rectum from the anus;
- intestinal perforation or rupture in the area of the operation;
- intestinal obstruction in the operated area associated with the accumulation of a large amount of feces;
- infectious-inflammatory or purulent processes in the place where the colostomy was previously located.
Colocolostomy also has a certain number of contraindications:
- atrophy or damage to the sphincter muscles;
- removal of more than thirty percent of the intestine when applying a stoma, in addition to the output from the rectum;
- a long course of chemotherapy for cancer;
- atrophy or more than fifty percent damage to the villous epithelium, since stagnation of fecal masses can be observed, which often leads to sepsis.
Recovery in the postoperative period
The recovery period after colostomy surgery is usually several months. And all possible complications often arise when at this moment the patient does not follow all the recommendations of the doctor, or is not performed in full.
When the recovery and rehabilitation period ends, only the attending physician decides on the basis of diagnostic studies of the intestine.
The most important thing in the postoperative period is to follow a diet and maintain a healthy lifestyle with a strict daily routine.
The dietary program during the recovery period looks something like this:
- 3-5 days after the operation, only droppers with the necessary medications;
- from the fifth to the twelfth day, you can eat only liquid cereals with added sugar;
- from the twelfth to the twenty-first day, it is allowed to gradually introduce other foods into the diet, with the exception of raw fruits and vegetables;
- only after three months have passed since the operation, you can start eating apple peels, corn, raw cabbage, legumes, fried and spicy foods.
Summing up
The operation to close the colostomy is one of the stages of reconstructive and restorative surgical intervention, in which the elimination of a temporary artificially created anus, brought to the front of the abdominal wall, is eliminated. One of the main conditions for such an operation is the absence of obstructions in the intestine along its entire length to the anus itself. Also important is the recovery rehabilitation period after such an intervention, which is characterized by a strict daily routine and a strict diet program for a long time.