Trephine Colostomy: Minimally Invasive Stoma Technique

Abstract

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.