Perineal Colostomy Post Amputation of Rectum

The operation described by Miles in 1908, an effective method in the radical treatment of tumors of the anus and lower rectum [1], and with better survival, leaves the stigma of the definitive iliac colostomy that leads to various psychosocial disorders [2]. Seeking to reduce social and family rejection, in addition to gas elimination and lack of control of the stools by the absence of sphincter, several methods of stools retention have been described [3-6]. Dr. Lázaro Da Silva, in Brazil, made the first perineal valve colostomy in 1991, when performing 2 to 3 extra-mucosal circular seromiotomies with invaginating seromuscular synthesis, with the meso-redundant occupying the pelvis, the distal valve stayed extra peritoneal and the proximal fixed to the promontory, this prevents or delays the excretion of stools directly [7]. It is indicated in patients proposed for abdominoperineal resection post-neoadjuvant, benign lesions with extensive sphincter involvement, extensive or intractable stenosis after perineal radiotherapy. This procedure is reserved for young or older patients in good physical condition, good cognitive level and without indication of postoperative radiotherapy [8].