Ostomy- Chapter One

Front 1

Surgical Maturation of the stoma refers to

Back 1

THe eversion and suturing of the distal bowel to the skin

Front 2

Which modification in the treatment of colorectal cancer has significantly reduced the number of patients who require a permanent colostomy?

Back 2

Guidelines for curative resection of rectal cancer revised to require a 2 cm distal margin.

Front 3

Attempts to develop a continent colostomy include all :

Back 3

1. Construction of a colonic reservoir connected to an abdominal stoma by an intususcepted colonic segment.
2. Use of intestineal muscle wrapped around the segment of bowel used to construct the stoma.
3. Neorectum constructed from decending colon

Front 4

The main advantanage of the coloanal J reservoir anastomosis is that it has shown a significant reduction in fecal frequency and urgency when compared to a recotsigmoid anastomosis. T/ F

Back 4

TRUE

Front 5

What are the major advantages of ileostomy surgery

Back 5

1. Areas of stoma construction and managment
2. Development of continent reservoirs
3. Development of pelvic pouches

Front 6

Charachteristics of ileostomy dysfunction include

Back 6

1. Obstruction of the ileostomy stoma
2. Intense inflammation and edema
3. Exposure of the serosal layer and spontaneous maturation of the stoma

Front 7

Name two advantages of the Brooke Ileostomy

Back 7

1.Produces a buddes stoma
2. Eliminates the temporary dysfunction associated with spontaneous maturation of the toma

Front 8

name a disadvantage of Ureterosigmoidostomy

Back 8

developement of carcinoma at the anastomtic site

Front 9

disadvantage of ureterostomy

Back 9

stenosis,poor emptying, major pouching difficulties

Front 10

Describe how and ileocecal pouch is created to be used as a continent urinary diversion.

Back 10

The reservior is contructed by opening and reconfiguring the cecum and possibly the right colon.

Debulularization successfully eliminated the problem of contractility in response to distention.

THe ureters are anastomosed to the secal reservoir( typically in an antirefluxing fashion) and the continence mechanism is created by phicating(folding) the cecum arond a 12 Fr catheter, which provides support for the native ileoceval valve.

THe distal end of the ileal segment is then sutured to the abdominal wall to create the catherizable channel.

Front 11

Name two significant advances in the field of fecal and urinary diversions taht have reduces the morbidity assocated with these major surgical procedures

Back 11

1. improved ability to identify the autonomic nerves controlling sexual funciton.

2. Increased use of laproscopic approach which reduces postop morbidity and recovery time