Type of Surgery

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Last updated: 11/24/2009

Diagnosis/Preparation

A number of diseases and injuries may require a colostomy. Among the diseases are inflammatory bowel disease and colorectal cancer. Determining whether this surgery is necessary is a decision the physician makes based on a number of factors, including...

patient history, amount of pain, and the results of tests such as colonoscopy and lower G.I. (gastrointestinal) series. Due to lifestyle impact of the surgery, the decision is made after careful consultation with the patient. However, an immediate decision may be made in emergency situations involving injuries or puncture wounds in the abdomen or intestinal perforations related to diverticulear disease, ulcers, or life-threatening cancer.

As with any surgical procedure, the patient will be required to sign a consent form after the procedure is explained thoroughly. Blood and urine studies, along with various x rays and an electrocardiograph (EKG), may be ordered as the doctor deems necessary. If possible, the patient should visit an enterostomal therapist, who will mark an appropriate place on the abdomen for the stoma and offer preoperative education on ostomy management.

In order to empty and cleanse the bowel, the patient may be placed on a low-residue diet for several days prior to surgery. A liquid diet may be ordered for at least the day before surgery, with nothing by mouth after midnight. A series of enemas and/or oral preparations (GoLytely or Colyte) may be ordered to empty the bowel of stool. Oral anti-infectives (neomycin, erythromycin, or kanamycin sulfate) may be ordered to decrease bacteria in the intestine and help prevent postoperative infection. A nasogastric tube is inserted from the nose to the stomach on the day of surgery or during surgery to remove gastric secretions and prevent nausea and vomiting. A urinary catheter (a thin plastic tube) may also be inserted to keep the bladder empty during surgery, giving more space in the surgical field and decreasing chances of accidental injury.



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To perform a colostomy, the surgeon enters the abdomen and locates the colon, or large intestine (A). A loop of the colon is pulled through the abdominal incision (B); then the colon is cut to allow the insertion of a catheter (C). The skin and tissues are closed around the new opening, called a stoma (D). (Illustration by GGS Inc.) To perform a colostomy, the surgeon enters the abdomen and locates the colon, or large intestine (A). A loop of the colon is pulled through the abdominal incision (B); then the colon is cut to allow the insertion of a catheter (C). The skin and tissues are closed around the new opening, called a stoma (D). (Illustration by GGS Inc.)




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Other Information

A colostomy is a surgical procedure that involves connecting a part of the colon onto the anterior abdominal wall, leaving the patient with an opening on the abdomen called a stoma. In a colostomy, the stoma is formed from the end of the large intestine, which is drawn out through the incision and sutured to the skin. After a colostomy, feces leave the patient's body through the abdomen. A colostomy may be permanent or temporary, depending on the reasons for its use.

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

A section of the colon has been removed, e.g. due to colon cancer requiring a total mesorectal excision, diverticulitis, injury, etc, so that it is no longer possible for faeces to pass out via the anus.

A portion of the colon (or ileum) has been operated upon and needs to be 'rested' until it is healed. In this case, the colostomy is often temporary and is usually reversed at a later date, leaving the patient with a small scar in place of the stoma. Children undergoing surgery for extensive pelvic tumors commonly are given a colostomy in preparation for surgery to remove the tumor, followed by reversal of the colostomy.


From http://en.wikipedia.org/wiki/Colostomy

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