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A 65-year-old woman with coronary artery disease and a history of abdominoperineal resection for a low rectal cancer 3 years ago presents with a painless peristomal bulge and an occasional appliance leak. She denies pain and reports normal colostomy output. Examination reveals a pink healthy colostomy and soft bulge medial to the stoma on application of the Valsalva maneuver. Result of recent surveillance computed tomography is available for review (Figure). What is the best management option?
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