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Related Concept Videos

Ostomy Care01:24

Ostomy Care

1.9K
Introduction
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
1.9K

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Diverting Ostomy: For Whom, When, What, Where, and Why.

Alexis Plasencia1, Heidi Bahna2,3

  • 1Jackson Memorial Hospital, University of Miami, Miami, Florida.

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|May 8, 2019
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Summary

This review highlights the critical role of fecal diversion in surgery. It recommends loop ileostomy over loop colostomy and outlines key indications for diverting stomas in various colorectal conditions.

Keywords:
Crohn's diseasediversiondiverticulitislow colorectal/coloanal anastomosis

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Fecal diversion is a crucial surgical technique.
  • Clinical indications for diversion remain debated.
  • Recent literature provides guidance on ostomy use.

Purpose of the Study:

  • To analyze current literature on fecal diversion.
  • To discuss common applications of diverting stomas.
  • To clarify controversies in ostomy usage.

Main Methods:

  • Systematic review of recent surgical literature.
  • Analysis of clinical scenarios requiring fecal diversion.
  • Discussion of ostomy use in specific patient groups.

Main Results:

  • Loop ileostomy is preferred over loop colostomy.
  • Ostomy is recommended for pelvic anastomoses <5-6 cm.
  • Diversion is frequently needed for severe perianal Crohn's disease.
  • Primary anastomosis with diverting ileostomy is safe for diverticular perforation.
  • Diverting stomas can facilitate primary resection in obstructing cancers.

Conclusions:

  • Diverting stomas are essential in specific colorectal surgical scenarios.
  • Evidence supports loop ileostomy preference and use in low anastomoses.
  • Fecal diversion offers safe and effective management options for complex conditions.