Stomas

All patients with stomas should have training and regular follow-up with a specialist stoma nurse.

 

Permanent (end) Ileostomy

  • After total colectomy for Inflammatory Bowel Disease (UC/Crohns) or Familial Adenomatous Polyposis (FAP)
  • Most often in lower right abdomen

 

Covering (loop) ileostomy

  • To protect distal anastomosis when removing colorectal cancers
  • Can be reversed at later date
  • See above

 

Colostomy

  • After abdomino-perineal resections (APR) for low rectal cancers
  • Permanent
  • Most often in lower left abdomen
  • Produces stools just like an anus

 

Urostomy

  • To allow draining of urine from kidney, bypassing the ureter, bladder and urethra (e.g cystectomy)
  • Ileal conduit urinary diversion
    • Section of ileum (15-20cm) is removed and end to end anastomosis is created
    • Ends of the ureters are anastomosed to this section of ileum
    • The end of the section is brought out onto the skin as a stoma
    • This stoma then works to drain urine directly from the ureters into a bag

 

Complications

  • Psycho-social impact
  • Local skin irritation around stoma
  • Parastomal hernia
  • Loss of bowel length leading to high output, dehydration and malnutrition
  • Constipation (colostomies)
  • Obstruction
  • Retraction
  • Bleeding
  • Granulomas
  • Prolapse (telescoping of bowel through hernia site)
  • Stenosis
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