Type of Surgery
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Last updated: 11/24/2009
Complications after colostomy surgery can occur. The doctor should be made aware of any of the following problems after surgery:
- increased pain, swelling, redness, drainage, or bleeding in the surgical area
- headache, muscle aches,...
dizziness, or fever - increased abdominal pain or swelling, constipation, nausea or vomiting, or black, tarry stools
Stomal complications can also occur. They include:
- Death (necrosis) of stomal tissue. Caused by inadequate blood supply, this complication is usually visible 12–24 hours after the operation and may require additional surgery.
- Retraction (stoma is flush with the abdomen surface or has moved below it). Caused by insufficient stomal length, this complication may be managed by use of special pouching supplies. Elective revision of the stoma is also an option.
- Prolapse (stoma increases length above the surface of the abdomen). Most often this results from an overly large opening in the abdominal wall or inadequate fixation of the bowel to the abdominal wall. Surgical correction is required when blood supply is compromised.
- Stenosis (narrowing at the opening of the stoma). Often this is associated with infection around the stoma or scarring. Mild stenosis can be removed under local anesthesia; severe stenosis may require surgery for reshaping the stoma.
- Parastomal hernia (bowel causing bulge in the abdominal wall next to the stoma). This occurs due to placement of the stoma where the abdominal wall is weak or an overly large opening in the abdominal wall was made. The use of an ostomy support belt and special pouching supplies may be adequate. If severe, the defect in the abdominal wall should be repaired and the stoma moved to another location.
Mortality rates for colostomy patients vary according to the patient's general health upon admittance to the hospital. Even among higher risk patients, mortality is about 16%. This rate is greatly reduced (between 0.8% and 3.8%) when the colostomy is performed by a board-certified colon and rectal surgeon.
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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.)
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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.
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