The Colostomy of Duret for the High Risk Patient

Abstract

Background: Heitzer and Duret described the surgical creation of colostomy in the 1700s, more than a century before the introduction of anesthesia. With the ever increasing degree of frailty in patients of advanced age who require surgical intervention, a simplified methodology for the creation of a colostomy based on their original reports is described and the advantages for use in high risk patients and the critical care setting is discussed. Methods: Eleven patients underwent simplified colostomy under local anesthesia, without complication. Results: All colostomies functioned normally within hours. There were no bleeding or infectious complications, nor peri-operative adverse events. Conclusions: Colostomy formation can be safely performed under local anesthesia when the patient is considered too high risk to undergo general anesthesia.

Keywords:

• colostomy
• high risk
• fecal diversion
• minimally invasive
• perineal trauma

Compliance with ethical standards

Ethical Approval: All procedures were performed in a prospectively on an ad hoc basis of necessity and patient safety, accordance with the ethical standards of the Institution.

Consent: Informed consent was obtained from all patients, or their designated healthcare proxy. Consent for publication is not required as patients are not identifiable in the Figures.

Availability of Data and Material: De-identified data and material can be provided upon request.

Declaration of interest

The authors declare that they have no competing interests.