We deviced "Stoma Button" for stomal stenosis which was complicated after cutaneous ureterostomy. Making process and directions for use of "Stoma Button" were explained. It could take effecte xcellently. We believe that our "Stoma Button" brings a solution to the treatment of stomal stenosis after cutaneous ureterostomy.

View full abstract

　On those colostomates presenting frequent skin troubles,possible factors in such disturbance were searched into by questionnaire,and approaches to improving such disturbance were examined via one case. The results obtained revealed the following：
1）Skin troubles of patients living at home involve not only stomal discharge according to the position and/or shape of the stoma,but also teaching for them on the part of medical care workers.
2）Home visits were paid to those patients presenting stomal discharge due to bad position and/or shape of the stoma. Two times of teaching led to their learning how to make skin care,and subsequent improvement of skin troubles.
　Improvement of skin troubles of patients living at home indicate establishment of home visit-nursing and like so as to be able to provide them with individual care and betterment of education ability on the part of medical care workers.

View full abstract

　A questionaire study about stoma rehabilitation and irrigation was performed on the members of the ostomy club in Niigata prefecture.
　Three hundred and thirty patients（76.9％）answered it,who were 183 men and 135 women and ranged in age from 17 to 85 years,with average of 62.6 and 62.1 years old respectively. Three hundred and two patients had left sided colostomy,which were studied about irrigation. One hundred and thirty-eight patients（45.7％）were chiefly managed by colostomy irrigation,2.8％ daily and 39％ on alternate days,whose average was 61.0 years old. On the other hand,the average of 184 non-irrigators was 64.5 years old（p＜0.05）. Forty percent of them had only one or two movements daily.
　There was no difference between men and women on the irrigation rate. But,there was a local area in which irrigation rate was significantly low.
　It was concluded that irrigation was an important method for management of left colostomy but its application should be selected by patients according to their personality,surroundings and life style.

View full abstract

　Inquiries were made of ostomates with a view to clarify their mental problems caused by different methods of elimination and by adaptive process for old or new prosthetic equipment and to find out possible method for supporting ostomates in their mental profile. The results obtained revealed the following：
1）Concerning to method of elimination,patients using irrigation method have greater self-esteem,smaller anxiety,and less complaint and mental problems about evacuation than that of patients by natural evacuation. So,the former method leads mentally patients to more stable daily life.
2）Old or new prosthetic equipments for the patients by natural evacuation do not make great difference in their influences on the mental profile of ostomates. This means that the progress in the equipment dose not necessarily lead to lessening compliants and mental problems about evacuation on the part of patient. The above suggests that mental support for ostomates involves means for lessening their inferiority complex aboute evacuation.

View full abstract

　Using questionnaire,status of bowel habits were analysed in 83 patients with left side colostomy who managed their colostomies by natural evacuation. All patients were interviewed by author alone for investigation.
　Comparing with the frequency of evacuation before operation,those after colostomy increased in 61.4％ of patients and most of patients needed at least one year to show the definitive bowel habits. 20.5％ of patients had regular time evacuation that took less than one hour,and 15.7％ showed irregular evacuation during sleeping hours. Namely,it was estimated that a total of 36.2％ could have the same degree of quality of life by natural evacuation as the patients who managed colostomies by irrigation.
　With these results,it was concluded that irrigation should be instructed after one year from colostomy.

View full abstract

　Eighteen patients with permanent colostomy were examined for colonic motility by manometric study. Seven patients were observed within 1 year after operation,five patients had defecated spontaneously over 4 years after operation,and six patients had undergone irrigation over 4 years after operation.
　Colonic compliance was larger in colostomy irrigation（over 4 years after operation）than in control group（within 1 year after operation）,or in spontaneously defecated group（over 4 years after operation）. Intracolonic baloon pressure was stabe in 4 out of 6 patients who had undergone irrigation,whereas it was unstable in all patients of control group and in 3 out of 4 patients who had defecated spontaneously.
　This study disclosed that colonic continence was gained by increased colonic compliance and stable colonic motility.
　From present results we suspected that colostomy irrigation was proper method to obtain colostomy continence.

View full abstract

　Colostomy irrigation is good method of management for sigmoid end colostomy. But little is known about physical influence from long term colostomy irrigation.
　We studied eight patients,who had been performing colostomy irrigation for more than five years postoperatively,regarding influence of colostomy irrigation on following aspects：
1）patient general condition such as nutritional status,renal function,electrolyte balance,liver function.
2）the anatomical structure of the colon.
3）the histological structure of the colonic mucosal.
4）the colonic bacterial flora.
5）the incidence of the second primary colonic cancer.
　There was no adverse effect from long term colostomy irrigation on those aspects mentioned above.
　We consider that colostomy irrigation is one of safe method of choice for management of sigmoid end colostomy.

View full abstract

　On the basis of answers to a questionary in which the patient subjectively described his own micturition,we grouped the responses into three stages depending on their scores and used these scores for postoperative training of urination. Since analysis of variance and t-test found a significant correlation between the score and the amount of urine pooled in the bladder or the amount of urination,we propose to determine the score of each patient when the amount of urine pooled in the bladder becomes 300～400 ml in a given period of observation during postoperative training of urination and to direct the patient to urinate when his response coincides with the determined score. In order to effectually perform training of urination using scores,it is necessary to make the patient fully understand the necessity of water ingestion and to check the amount of water ingestion and the total amount of urination.

View full abstract

　We reviewed 6 patients who required reconstructive surgery for complications of colostomy between 1983 and 1986 in our Department. Two cases had early complications after the sigmoid colostomies performed at our hospital. Those were necrosis and retraction. For these new transverse loop colostomies were performed,then the original sigmoid colostomies closed spontaneously within 4 weeks in both cases. Late complications observed on 4 cases after colostomies done at another hospitals were parastomal hernia,stenosis,prolapse with parastomal hernia and retraction. New colostomies were reconstructed at new abdominal sites in these cases. In all 6 cases,new colostomies were built completely through the rectus abdominal muscle by means of primary opened and mucosal everting method. There were no complications following reconstruction. Complications of colostomy can be avoided by the careful meticulous technique based on the fundamentals.

View full abstract