Trephine Colostomy: Minimally Invasive Stoma Technique.

Aims: Stoma is an important part of surgical management of numerous malignant or benign anorectal diseases and anorectal injuries. This can be performed without recourse to laparatomy. This study was aimed to assess the outcome of trephine to loop sigmoid colostomy creation. Study Design: The retrospective study included 18 patients who underwent trephine colostomy due to various conditions including Fournier’s gangrene, inoperable anorectal cancer, recto-vaginal fistula, fecal incontinence, and rectal injury. Place and Duration of Study: Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Surgery between January 2005 and January 2015. Methodology: The retrospective study included 18 patients who underwent trephine colostomy. Demographic characteristics, primary pathology for colostomy decision, length of hospital stay, anesthesia technique, and early period surgical complications at 3 months were recorded. Results: Patients comprised 11 males and 7 women with a mean age of 53±5 years. The indications for stoma formation were Fournier’s gangrene in 8 cases, inoperable anorectal cancer in 3 cases, high recto-vaginal fistula in 2 cases, fecal incontinence in 3 cases and rectal injury in 2 cases. Regional anesthesia was performed in 12 and general anesthesia in 6 cases. Only one patient (5.6%) had stricture of the stoma. There were no other complications and no additional morbidity and mortality related to TS technique. Conclusion: Trephine stoma is a relatively simple, safe and rapid procedure and an effective alternative to colostomy formation without laparotomy indications.

Diversion Colitis: Diversion Colitis A case report

Pseudomyxoma peritonei may result from implantation of benign or malignant tumor in peritoneal cavity and is filled with gelatinous material (termed "Jelly Belly") in abdominal cavity. Its origin is usually an appendiceal or ovarian mucinous adenoma or cystadenocarcinoma, but other primary origin such as uterus, intestine, pancreas and stomach umor have been reported. Generally, pseudomyxoma peritonei is slowly progressive and has low grade malignant potential. This report presents a unusual long term survival after evacuation of 15,000 cc of gelatinous material from abdominal cavity which was the low grade mucinous adenocarcinoma and a review of the current literature, management and new its concept. The origin of pseudomyxoma peritonei of this case was most likely from appendiceal mvcinous adenocarcinoma.