To determine the long-term problems in care of patients with colostomas,we conducted a survey of patients who had undergone either abdomino-perineal resection or Hartmann's procedure for rectal tumors. Of the 161 questionnaires,92 were returned. Information was collected concerning the patients' current condition as well as details about management of defecation and dermatitis in the first six months after surgery.
　It was found that of the 80 patients who had used intestinal lavage in the first 6 months after surgery,13 now evacuated naturally; nonetheless,as many as 67 percent of patients still relied on lavage,indicating that the method continues to be effective for management of defecation.
　Skin inflammations were present in 38 cases(41％ of respondents),with 36(95％) caused by the pouch. Symptoms were fairly light,however,with only some reddening,and the incidence was only 2-3 times a month. The application of a salve and attention to hygiene was usually sufficient treatment.
　There was,however,one case where the use of an inappropriate pouch caused persistent inflammation,and another where the patient tolerated dermatitis for lack of awareness that other pouch types were available. It is important,therefore,to give patients adaquate guidance concerning the use of pouches.

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　We studied methods to effectively manage colostomies in order to enhance the quality of life（QOL）of colostomy patient's by comparing the efficacy of colostomy irrigation with natural evacuation. Questionnaires were sent to 66 patients who had undergone abdomin operineal resection for rectal cancer. Thirty-six patients irrigated their own colostomies and 30 patients evacuated naturally without irrigation. This study revealed that colostomy irrigation was more effective than natural evacuation in enhancing the QOL of colostomy patients,despite the fact that the majority of patients who irrigated their own colostomies experienced stool spillage. It was concluded in this study that medical staff should thus advise patients on more effective techniques of managing their colostomies,in paticular regard to irrigation.

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　In recent years in Japan,music therapy,a form of art therapy,has been the object of public interest as a means of medical treatment.
　The utilization of music therapy,a form of non-verbal communication,is aimed at achieving the following results; improvement in a patient's ability to communicate; recovery from prolonged states of inactivity; increase in social adaptation; and the promotion of other mental and physical functions.
　It was thought that the preoperative and postoperative use of a Body Sonic bed pad（Body Sonic Co.,Japan）would have a calming effect on stoma patients,thereby reducing the anxiety,shock and depression which can result from the bodily changes caused by stoma surgery. This method of treatment was therefore applied to a 48-year-old female patient with rectal cancer,to whom the Miles procedure had been performed.
　Although the patient was sometimes emotionally unstable during her stay in the hospital,she was immediately able to care for herself independently,returning quickly to the routine activities of daily living.

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