Patient Information
Digestive System
The function of the digestive system is to provide nutrients to all body cells.
Colorectal Cancer
Colorectal cancer is a malignant tumour that can be located at different levels inside the large intestine. It can be located at the level of the colon or at the end of the intestine, in the area called rectum.
Medical team in charge of drafting the Patient Dissemination section
Ostomies
written by Dr. Josep M. Montané Sorigué
“And Ehud put forth his left hand, and took the dagger from his right thigh and thrust it into his belly. And the haft also went in after the blade: and the fat closed upon the blade, so that he could not draw the dagger out of his belly, and the dirt came out” Judges 3:21-22
This could be the first definition of a colostomy. Ostomies have always been associated to the violent side of mankind, especially during warfare.
Hippocrates (460-377 b.C) had already stated that wounds to the large instestine were fatal but not those to the small intestine.
Cromar (1968) reported that a soldier by the name of George Dappe who was wounded in the battle of Ramillies in 1706 lived for 14 years with a traumatic colostomy caused by a wound. This is probably the first reference of double-barrel colostomy.
Thomas Sydenham, a London surgeon from the 1800s treated occlusions attempting to pass a needle through the stenosis and recommended large amounts of mercury as its weight pulled at the occlusion. Clearly, these sort of treatments caused death to the patient.
The first scheduled ostomy was performed by a French surgeon by the name of Francés M Pilore in 1776 to manage an occlusion that did not respond to any treatment.He performed a cecostomy and sutured it to the skin using a sponge as a dressing. There were no complications during the first two weeks but the patient died. The autopsy revealed necrosis of the intestine due to the intake of mercury prior to surgery.
The first colostomy performed successfully was a left inguinal colostomy also carried out by a French surgeon by the name of Duret in 1793 on an infant who lived to the age of 45.
The first surgeon to perform a colostomy was George Freer in 1815 to treat a 47-year old farmer who had a malignant rectal occlusion.
Professor Fine, from Genève was also a pioneer in the history of surgery. In 1797 he performed the first transverse colostomy although in error, as what he really wanted to perform was an ileostomy to treat an occlusion but three months later after the autopsy he realised he had made a mistake.
Hendrik Collissen(1740-1824) described in his book the surgical technique to perform a colostomy via lumbar access in order to avoid the risk of peritonitis. This procedure was not accepted because of its technical complexity.
The second British surgeon to perform a colostomy was Daniel Pring who in 1820 performed a sigmoid colostomy on a woman also by the name of White. This surgical procedure was the first to describe dermal complications in the stoma and the first to report how the faecal matter is kept inside the stoma.
Generally, few surgeons dared to perform intestinal surgery as the peritoneum was accessed leading to potential lethal sepsis. Jean Amussat, a French surgeon, was of the opinion that surgeons did not want to compromise their reputation performing what was considered to be high risk surgery with a bad prognosis. A retrospective review of the literature showed that between 1716 and 1839 only 27 cases on colostomy had been published but only 6 of these lived.
As said before, the advances made in colostomy were unfortunately associated to warfare. In fact, it was in the Second World War when wounds to the abdomen and their treatment contributed the most to the development of the techniques to perform colostomies and their complications.
The first person to realise that ostomised patients needed special care was nurse, Elise Sorensen. The creation of first consultation office for the care of the ostomised patient was created was her own merit.
In our country, probably the first ostomy clinic was founded by Dr. Josep M. Montané Sorigué and the nurse Eva Gimeno, at the Creu clinic in Sabadell in 1976.
The development and advancements made in contention devices has been dramatic over these last few years, making the social life of ostomised patients practically normal. Behind barrier rings through obturators and seals, there has been and there is a long and fruitful research effort.
At present one of the most prestigious consultation offices is the Coloproctology Unit at the Pac Taulí University Hospital in Sabadell, Barcelona, directed by registered nurse Carmen del Pino. I. Carmen del Pino.
General objectives of the ostomy care unit
To favour the continuity of the healthcare process.
To conduct proper patient education providing ostomised patients
their main caregivers with the necessary skills and knowledge to perform adequate stoma care.
Health education aimed at the prevention of late complications.
Get the ostomized person to rediscover their biological, psychological and social balance.
To work in a multidisciplinary manner with other health professionals attending ostomised patients.
To favour the continuity of the healthcare process.
To conduct proper patient education providing ostomised patients
their main caregivers with the necessary skills and knowledge to perform adequate stoma care.
Health education aimed at the prevention of late complications.
Get the ostomized person to rediscover their biological, psychological and social balance.
To work in a multidisciplinary manner with other health professionals attending ostomised patients.
What sort of patients that can come to this Unit?
- Patients who have ostomies for bowel elimination:
– Digestive stomas: colostomies, ileostomies, jejunostomies,etc.
– Urologic stomas: skin urostomies, ureteroileostomy,nephrostomy,etc.
- Patients with high-debit enterocutaneus, vesical or biliary fistulas.