L. Carson et Ev. Lang, PERCUTANEOUS COLOSTOMY FOR TREATMENT OF MECHANICAL BOWEL OBSTRUCTION - FACTORS AFFECTING FEASIBILITY, Journal of vascular and interventional radiology, 7(4), 1996, pp. 561-567
PURPOSE: To assess the feasibility of large-bore tube colostomy in the
presence of bowel obstruction in a pig model. MATERIALS AND METHODS:
Porcine spiral colon was isolated, obstructed, pressurized to 18 mm Hg
, punctured with 24-F radial dilators or balloon-sheath combinations i
n randomized sequences, and assessed for leakage. In another experimen
tal set, T tacks were used. The effects of various drainage configurat
ions and systems (open vs closed) on drainage and leakage were assesse
d during continued gut perfusion. RESULTS: Pressurized colon leaked 0-
19.8 mL during radial dilation, 0-210 mL during balloon-sheath dilatio
n, and 7.4-29.8 mL/min at T-tack sites. Leakage increased with minor m
otion. Leak-free drainage during perfusion could be obtained only with
open systems or with closed systems that were inserted at least 10 cm
proximal to the obstruction. CONCLUSION: Percutaneous colostomy shoul
d only be attempted in very select cases with extreme attention to det
ail.