A Case of Laparoscopic Colostomy in a Patient With Defecation Disorder Due to Spinal Cord Injury
- VernacularTitle:排便障害を伴う脊髄損傷患者に対し腹腔鏡下人工肛門造設術を施行した1例
- Author:
Yuki SUNAGAWA
1
;
Ikue NONOGAKI
2
;
Akira MIZUNO
1
;
Shinya KOIKE
2
;
Koichiro TAGAMI
1
Author Information
- From:Journal of the Japanese Association of Rural Medicine 2020;69(4):395-
- CountryJapan
- Language:Japanese
- Abstract: The patient was a 73-year-old man. He had sustained a spinal cord injury in a work-related accident at 40 years of age and was living with lower body paralysis. He had defecation disorder due to poor intestinal peristalsis of the sigmoid colon. Colostomy was indicated because the defecation disorder had worsened to the extent that hospital management was required. We selected a laparoscopic approach for two reasons. First, at the time of the accident, he had undergone thoracotomy and laparotomy to treat diaphragm injury and we expected that adhesions would need to be removed in the abdominal cavity. Second, patients with spinal cord injury are prone to poor bowel peristalsis, and minimally invasive surgery should be used to prevent postoperative paralytic ileus. The operation was performed with three ports. Adhesions of the transverse colon, omentum, and abdominal wall were peeled off, the transverse colon was mobilized, and a transverse colostomy was created in the upper right abdomen. The postoperative course was favorable, and he resumed eating on postoperative day 2. Laparoscopic colostomy for patients with spinal cord injury and defecation disorder can be a safe and effective technique for improving quality of life.
