Avoidance of a colostomy by nutritional techniques

Total parenteral nutrition or elemental diet has frequently replaced the use of a proximal stoma. Since 1969, data on patients receiving these non-residue nutritional methods have been collated daily; there were 63 patients where the surgeon believed that a proximal stoma would otherwise have been indicated. In 35 patients, these methods were used prophylactically perioperatively and in 28 patients, they were instituted postoperatively after complications occurred; in both groups, there was a very high rate of successful outcome. Modern nutritional support avoided fecal bulk while maintaining nutrition, and appeared to accomplish the equivalent of a diverting proximal stoma with considerable success in other than Crohn's disease.