Colostomy

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Colostomy
Intervention
Diagram showing a colostomy with a bag CRUK 061.svg
Diagram showing a permanent colostomy
ICD-9-CM46.1
MeSHD003125
MedlinePlus002942
 
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Not to be confused with Colonoscopy, Colotomy, or Corpus callosotomy.
Colostomy
Intervention
Diagram showing a colostomy with a bag CRUK 061.svg
Diagram showing a permanent colostomy
ICD-9-CM46.1
MeSHD003125
MedlinePlus002942

A colostomy is a surgical procedure in which a opening (stoma) is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. It may be reversible or irreversible depending on the circumstances.

Indications[edit]

There are many reasons for this procedure. Some common reasons are:

Options[edit]

Illustration depicting various types of colostomy

Placement of the stoma on the abdomen can occur at any location along the colon, but the most common placement is on the lower left side near the sigmoid where a majority of colon cancers occur. Other locations include the ascending, transverse, and descending sections of the colon.[1]

Types of colostomy:[2][3]

Colostomy surgery that is pre-planned usually has a higher rate of long-term success than surgery performed in an emergency situation.[citation needed]

People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed a couple of times a day depending on the frequency of activity; in general the further from the anus (i.e., the further 'up' the intestinal tract) the ostomy is located the greater the output and more frequent the need to empty or change the pouch.[4]

Colostomy with irrigation[edit]

People with colostomies who have ostomies of the sigmoid colon or descending colon may have the option of irrigation, which allows for the person to not wear a pouch, but rather just a gauze cap over the stoma, and to schedule irrigation for times that are convenient.[5] To irrigate, a catheter is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve.[6] Most colostomates irrigate once a day or every other day, though this depends on the person, their food intake, and their health.

Alternatives[edit]

A UK man has been given a remote-controlled bowel.[7] Colostomy or ileostomy is now rarely performed for rectal cancer, with surgeons usually preferring primary resection and internal anastomosis,[8] e.g. an ileo-anal pouch. In place of an external appliance, an internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to act as a new rectum to replace the removed original.

See also[edit]

References[edit]

  1. ^ Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada.p1393
  2. ^ Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada. p1393-1394
  3. ^ http://oncolex.org/en/Colorectal%20cancer/Procedures/TREATMENT/Surgery/Anleggelse%20av%20stomi?lg=procedure
  4. ^ "Colostomy irrigation: Colostomy Guide". United Ostomy Associations of America. Retrieved 4 February 2013. 
  5. ^ Rooney, Debra. "Colostomy irrigation: A personal account managing colostomy". Ostomy. Retrieved 7 September 2012. 
  6. ^ Wax, Arnold. "What is colostomy irrigation?". WebMed. Retrieved 7 September 2012. 
  7. ^ Man-uses-remote-to-control-his-bionic-bottom The Telegraph]
  8. ^ al.], senior editors, Bruce G. Wolff ... [et (2007). The ASCRS textbook of colon and rectal surgery. New York: Springer. p. 417. ISBN 0-387-24846-3.