Treatment methods for common complications of artificial anus surgery

With the improvement of medical technology, the survival time of colorectal cancer patients after artificial anus surgery has been extended. However, surgery can also cause a series of complications, and patients should be aware of them and understand the relevant treatment methods.

Stoma bleeding

It often occurs within the first 72 hours after surgery. Most of the bleeding is from capillaries and small veins at the junction of the intestinal stoma mucosa and the skin. It can be stopped by a little pressure with a cotton ball or gauze. If the bleeding is more frequent, you can use gauze soaked in 1‰ epinephrine solution for pressure or apply Yunnan Baiyao powder externally. More bleeding may be caused by the failure to ligate the mesenteric arterioles or the ligature falling off. At this time, 1 to 2 mucosal-skin sutures should be removed, and the bleeding points should be found and clamped to stop the bleeding completely.

Enterostomy infection

This is one of the most common complications, often caused by skin incision infection, which can occur under the skin or in the deeper abdominal wall layer. It starts with redness, swelling and pain, followed by the formation of abscesses, some of which can break through on their own and discharge pus, forming scars after healing, leading to stoma stenosis. There are also cases where abscesses evolve into fistulas and do not heal for a long time.

If early infection is detected, cleaning and wet compresses should be applied, and anti-inflammatory treatment should be strengthened. If an abscess is formed, early incision and drainage should be performed to remove the thread ends. If a fistula has formed, fistula resection or re-enterostomy is often required.

Enterostomy edema

Stoma mucosal edema can be seen 2 to 5 days after colostomy surgery. Generally, no treatment is required and it will slowly disappear after 1 week. If the stoma mucosal edema worsens and becomes grayish white, check whether the stoma blood supply is sufficient, and apply saline or furazolidone solution for continuous wet compresses. If necessary, add external irradiation with a spectrum analyzer.

Enterostomy stenosis

One week after colostomy surgery, dilate the anus with fingers (wearing gloves or finger cots) once a day until the second section of the index finger can be inserted. Colostomy stenosis is mainly caused by the abdominal wall hole being too small or part of the fascia not being removed, or the formation of a scar ring after infection. Mild stenosis can be dilated twice a day with the above method until the second section of the index finger can be inserted. Severe stenosis requires incision or removal of scar tissue around the stoma, and re-suturing of the intestinal wall and skin edges.