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Tube ileostomy method in colon cancer surgeries

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Tube ileostomy method in colon cancer surgeries

When an American general discovered the “stoma” during World War I, when the death rate in people carrying intestinal viruses was very high, the 100-year-old story began that day.

When an American general discovered the “stoma” during World War I, when the death rate in people carrying intestinal viruses was very high, the 100-year-old story began that day. Thanks to this new application, the intestine was brought closer to the abdominal wall and taken out through the hole (diverting stoma), creating a new outlet for food waste. In this way, the waste was taken out of the body before it reached the injured areas in the lower part of the intestine and poisoning of the patient was prevented. This method called “ostomy”, which can be applied temporarily or permanently, is also used in today’s medicine. While ostomy, which has been successfully used as a life-saving method especially in colon cancer treatments, has been on the medical scene for a century, the story continues today with innovative perspectives. Anadolu Health Center General Surgery and Colorectal Surgery Specialist Assoc. Dr. Vafi Atalay developed the method and turned it into a more comfortable treatment process for patients. Dr. From Atalay, we not only learn the classical tube ileostomy method; We also learn what difference the method he developed, which was published in Colorectal Disease, the international scientific journal of the world of surgery, brings to the lives of colon cancer patients in particular…

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In what situations is it needed?

As it is known, colon cancer (large intestine) is one of the types of cancer whose frequency has increased in recent years. According to figures, it is the 3rd most common cancer in the world and one of the leading causes of cancer-related death among both men and women. However, it is among the most treatable cancers when diagnosed and treated in its early stages. In fact, the five-year survival rate for those diagnosed and treated at an early stage is very high, at 90%. Colon cancer, which manifests itself with symptoms such as disruption of the defecation pattern (diarrhea, constipation), bleeding or blood in the stool, pain while defecating, transparent secretion in the stool, abdominal pain and swelling; It is aimed to increase the patient’s life expectancy and quality, especially due to genetics and age. While tumor parts are removed through surgical treatments in many patients, it becomes risky for the patient to defecate naturally before the surgical area heals. At this point, the ostomy method is associated with many factors such as chronic bowel diseases, tobacco use and unhealthy diet. We can say that it comes into play in the treatment of colon cancer, which is usually diagnosed by colonoscopy. In addition to colon cancer; This method, which is also used in cases of rectal cancer, trauma, intestinal disease or some birth defects that prevent defecation, can sometimes be applied when there is intestinal injury during repeated caesarean sections. If the surgeon brings the large intestine to the abdominal surface and creates an opening there (stoma), it is called colostomy. If the surgeon brings the small intestine to the anterior abdominal wall and mouths it, this is called ileostomy. The purpose of the stoma, which is created to connect the intestine to the bag (a disposable ostomy bag to collect the stool); To temporarily or permanently remove the contents of the intestine through the opening in the abdominal wall. When recovery is completed after the surgery, the intestine is removed with a second surgery and the stoma created in the abdomen is closed.

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Living with a colostomy is, first of all, a cause of psychological trauma. While the intestine can come out with a little straining or coughing, it can sometimes leak inside. In addition, the hole in the abdominal wall can grow over time and turn into a hernia. There is also a risk of infection and skin burns due to the stoma. In this respect, maintenance and daily cleaning can be tiring and wearing. When it comes time to close the stoma, a very delicate surgery is required again. During this process, it is important that there is no leakage from the intestine into the abdomen in the future. Although it has its difficulties, we must underline that the method has a life-saving role in the patient groups we mentioned, that is, in compulsory situations.

What are the differences of the new method?

As an alternative to colostomy, ideas such as inserting a tube through the opening in the abdomen were studied 40 years ago. Thanks to this idea called “tube ileostomy”, it is aimed to prevent the intestine from being removed and to prevent it from becoming permanent. In fact, practices to prevent leaks by inflating a balloon inside the intestine have also been tried. However, although all of these have been supported by scientific publications over the years, they have not been widely used due to their ineffectiveness.

What is the tube ileostomy method?

In the new method developed, different materials are used (as seen in the drawing above). The new material used does not bend in any way, but it has a flexibility that does not restrict the patient’s movements such as sitting and lying. This is thanks to a special spiral inside the material. The second most important difference is an inflated balloon and a special maneuver system used to prevent the possible passage of food waste into the surgery area below. This is done thanks to a special band passed through the intestine, so that food waste does not go down around the tube. After this surgery, which takes only 10 minutes, there is no need for a second surgery, the intestine does not remain outside. This tube can be used in any surgery where a temporary bag will be used. The tube is removed after 2 weeks without the need for surgery, and the hole heals in 2-3 days. The method, which has been applied to many patients to date and can be used at all ages, is also successful in follow-up. First of all, it is undoubtedly the greatest comfort for the patient to go home without a bag…

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Is early diagnosis important?

Colon cancer, the 3rd most common cancer in the world, is among the most treatable cancers when diagnosed early and treatment is started. In fact, the five-year survival rate for those diagnosed and treated at an early stage is very high, at 90%.

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