Response

The type of procedure described in this Letter to the Editor is not widely reported in the colorectal literature and not commonly performed in North America. While there are several articles reporting on this procedure, widespread acceptance of the procedure is lacking. Based on this paucity of evidence, I urge caution regarding the implication of the original authors (Souadka and Majbar) that patients may not have needed to undergo an APR but rather should have the surgery suggested in this letter. It should be pointed out that a single health-related quality-of-life study of this patient population found no difference between traditional stoma patients and patients undergoing the perineal colostomy.1 Additional research is needed to determine long-term outcomes of the perineal colostomy and its relationship with bowel elimination symptoms following surgery.

Janice Colwell, MS, RN, CWOCN, FAAN

University of Chicago Medicine

Chicago IL 60605

[email protected]

Reference