We have executed surgical treatment on two cases with ileal conduit peristomal skin exhibiting various problems and having difficulty in self-care.
　In case #1,the peristomal skin disorder consisted of abnormal elevation of a portion of the skin,accompanied by pseudoepitheliomatous hyperplasia（PEH).
　In case #2,the peristomal skin always came in contact with urine and PEH exhibited.
　Due to the fact that ware limitations in the selection of stomal equipments and application techniques,we have requested cooperation of plastic surgeons with the reconstruction of the peristomal skin as an alternative treatment.
　As a result,ease and stability in the application of the stomal equipments,facilitated self-care,in addition to relief of psychological and financial burden imposed by frequent changing. Thus,the surgical treatment proved effective in these cases.
　In such cases where the quality of life deteriorates due to difficulties in stomal care,a plastic treatment may prove useful,with considerration to the patient's age and recuperative strength.

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　Although we have recently adopted rectal sphincter preserving method using stapling technique for rectal reconstruction,colostomy is an usual manner as surgical treatment of rectal cancer still now.
　We investigate the complications after making colostomy in our institution for last 15 years. There are 21 of 354 patients who had colostomy after rectal cancer surgery. These include prolapse of the colon in 11,intestinal obstruction in 6,intestinal stricture in 2,perforation in 1 and gangrene in 1. Colostomy repair,intestinal resection,colostomy renewal,peritonitis operation were taken as one of the surgical interventions for these complications.
　We should give careful attention to the serious effect of making colostomy on the body and mind of each patient as well as the treatment for rectal cancer. And also it should be more important to make well functioning colostomy without any complications.

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　For measuring stoma size,we usually use a nogis（caliper）or a stoma-guage,which are commercially available. As it is rather difficult to measure the accurate size of convexoconcave or mushroom shape stomas with these instruments,we developed a new tool.
　In order to easily take the mold of skinattachment of a colostomy,we came up to develop a new tool which has about 2 times lager cicumference than a regular stoma-guage and composed of about 6 parts.
　We could measure stoma-size with complexed shapes by putting these device around the stomas and transfer exact shapes on a paper. The new device did not require any experience for use.

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