Introduction
The word 'stoma' literally means 'mouth' in Latin and in colorectal surgery describes the creation of an artificial opening made in either the colon (large intestine) or the ileum (small intestine) called a colostomy or ileostomy respectively.
There are many reasons why a stoma may need to be created. Common reasons include protecting the bowel if a section has been removed, infection, trauma or injury. Conditions that may require a stoma as part of treatment include colorectal cancer, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis), bowel obstruction and diverticulitis.
A stoma can be a temporary arrangement, with the affected sections of the bowel reconnected in a procedure at a later date (called a stoma reversal), or it can be permanent.
The stoma itself is located on the external skin of the abdomen. With a colostomy this is generally on the lower left-hand side of the abdomen and with an ileostomy, generally on the lower right-hand side. A pouch or bag is then attached to collect bodily waste.
Procedure
Stoma surgery is conducted under a general anaesthetic. The location of the stoma on the outside of the abdomen is marked (generally by a stoma nurse) and then an incision is made at the site of the stoma to bring the bowel out to the skin and secured with stitches. A plastic pouch or bag is attached over the stoma for collection of bodily waste.
Postoperative Instructions
After the procedure the nursing team or stoma therapist educates patients to allow them to look after the stoma themselves. This support continues after discharge from hospital with the main goal to allow patients to transition back to a normal lifestyle.
Risks
The risks of stoma surgery include:
- Dehydration.
- Parastomal hernia.
- Infection.
- Stoma narrowing or retraction.
- Stoma prolapse.
