The guidance about colostomy irrigation has been given to all of the patients who were performed permanent sigmoid colostomy before discharge,in our hospital. The appropriate volume of the irrigation water is thought the volume of remnant colon. This volume was decided by barium enema. Questionnairing was conducted on the member of colostomy patients association. The evaluation of measurement of the volume of remnant colon was investigated and reported. The number of patients who replied submitted to the questionnaire was 64（40 males,23 females and 1 no answer). 21 patients had measured remnant colon volume. 90. 3％ of the patients who were irrigated their colostomy regularly were satisfied with colostomy irrigation. The mean volume of remnant colon was 620ml,the mean volume of irrigation water was 680ml in the patients who had measured remnant colon（Group A）and 745ml in the patients who did not have measured（Group B). Simptoms after colostomy irrigation recognized 14.3％ of the patients in the Group A and 20％ of the patients in the Group B. The rate of defecation within 24 hours after colostomy irrigation was 19％ of the patients in Group A and 60％ in Group B. This was a significant difference. In conclusion,measurement of the volume of remnant colon was useful.

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　The new composition skin barrier and two kinds of skin barrier on the market were tested comparatively on the subject of state of swelling and dissolving that occured while they were applied to the skin of human.
　Patch tests were carried out on 9 healthy men. The patches were applied 3 times consecutively for 3 days at a time. The outer surface of the skin barrier was attached to a pouch containing water.
　The water was changed once a day. The amount of swelling and dissolving was measured each time water was changed. Peeling power was checked each time the patches were changed.
　The results were as follows：
1. For 3 day patch test,the new composition skin barrier did not dissolve,but the 2 kinds of skin barrier on the market dissolved to a large extent.
2. The scroll adhesive skin barrier peeling power increased as application was repeated.The other kinds did not.

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　We made inquiries of seven hundred twenty six ostomates on problems from that they suffered. In questionnair they ranked seven items of problem according to the degree they suffered from problems.
　On the basis of the dynamic stoma rehabilitation,we analysed the relationship between problems and time after operation. From the information obtained it became obvious that they most worried about health in the future and recurrence of the primary disease through all periods. And,even more than ten years after operation,seventy seven percent of the ostomates had some kind of problems,although the incidence of the problems was gradually declining.
　It was important in the stoma care that we should also consider their annoyance about the primary disease as well as stoma care itself. And the patients who spent more than five years after operation could get appropriate information about the primary disease and their annoyance.

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　The management of ileostomy was discussed in seven patients treated by open drainage and ileostomy for severe acute pancreatitis and severe peritonitis. Ileostomy was useful in avoiding the deterioration due to colonic perforation during the peritoneal lavage and in reducing the bacterial flora in the colon. The problems in stoma care arose in view of 1. stoma site. 2. complication of stoma. 3. skin trouble and 4. stoma appliance. There were many skin troubles in patients who didn't receive stoma site marking preoperatively. Preoperative stoma site marking diminished the risk of skin trouble. The application of devices such as Tegaderm or Surgidrain-opentop were useful appliance in preventing the absorption of exudate from the open wound. The conclusions were obtained as follows；1. Stoma site marking should be done preoperatively. 2. Stoma should be placed at a sufficient distance from the wound edge. 3. Stoma appliance should be selected according to the condition of stoma.

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　Urostomates have lots difficulties to collect and to store urine without leakage during sleep in the night.
　We suggested urostomates to use Incare Urinary Leg Bag System during sleep. The Incare Leg Bag System are made from durable vinyl and have a pleated design which offers capasity without bulkiness. They feature a no-flowback valve which assures that urine will not flow back even if the patient lays down. The bag is fixed at the leg by strap and this does not interfere the patient to move free. The patient can sleep well without waking up till morning.

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　For the patient who has to receive an urinary diversion,a stoma care is one of problemati-cal burden physically and mentally. Continent internal reservoir constructions using intestine,colon or rectum have been developed in recent years. The creation of a satisfactory urinary reservoir requires some functional mechanisms that it be of adequate capacity,low pressure and functional valves（preventing reflux valve and continence providing valve）. The Kock pouch as a means of continent urinary diversion using ileum after cystectomy has been performed in 68 cases since 1984 in our institute.
　Herein Kock pouch will be discussed including the procedure of the operation.

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