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2015, Number 5

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Rev Clin Esc Med 2015; 5 (5)

Beneficios de la colostomía en la calidad de vida del paciente con lesión medular crónica y ventajas de su realización por vía laparoscópica

Leitón CA, Hu LH, Ramírez VJM

Language: Spanish
References: 16
Page: 35-44
PDF size: 869.65 Kb.


ABSTRACT

Recent research suggests that the management of bowel problems is a major source of concern for patients with spinal cord injury and can significantly affect quality of life. The most common gastrointestinal symptoms found were constipation and fecal incontinence, reported by 46% and 41%, respectively. Bloating was reported by 22% and gastrointestinal pain (abdominal pain, rectal or anal) was reported by 33% of patients.
Not surprisingly, gastrointestinal symptoms are associated with depression, anxiety, and significant deficiencies in the quality of life in a significant portion of people with spinal cord injury.
Given the severity of these symptoms, several authors have argued that invasive surgical options, including intestinal diversions (colostomy or ileostomy) or creating a Malone antegrade continence enema (MACE), can provide superior results for selected patients with severe neurogenic bowel dysfunction after spinal cord injury. The advantages of laparoscopic colostomy include, particularly, the possibility of avoiding a wide laparotomy with all its risks. Some authors report lower adhesion formation after laparoscopy which reduces the risk of blockage and facilitates transit reconstruction in temporary colostomies. The indisputable advantage is the minimally invasive access to patients.


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