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