Stoma creation and reversal

Indication:

The procedure is done for the following reasons: inflammatory conditions, functional disorders, injury to the colon or cancers of the colon, rectum, and small bowel.

The section/portion of bowel to be exteriorized depends on the location along the bowel which needs to be resected or treated. There are three types of stomas:

Ileostomy – performed for conditions such as ulcerative colitis or after the removal of the colon. The transected end of the portion of the small bowel named the ileum is brought through the abdominal wall and a portion is turned inside out and stitched to the skin surface.
Double-barrel – usually performed as a temporary measure, the bowel is divided and both ends are brought to the margins of the skin incision and sutured to the skin. (Loop colostomy/ileostomy)
Colostomy – performed to render a segment of the bowel non-functional. Commonly performed following an anterior resection (resection of portion of large intestine), Abdomin-perineal resection, or as part of a Hartmann’s operation. A mucous fistula may be fashioned in addition to this procedure. This can be performed at several sections of the large intestine.
Reversal of Ileostomy or Colostomy – performed to restore the continuity of the intestinal tract. If performed open, involves either a circular incision around the stoma or possibly through the previous laparotomy (midline) incision. Reversal of loop ileostomies or colostomies can generally be performed through the circumferential incision around the stoma whereas reversal of end-ileostomies or colostomies usually involves opening the old scar to safely access the bowel. The bowel ends are reconnected which is called an anastomosis, and the wound is closed.

Possible complications:

Bleeding – intra-operatively and/or post-operatively
Leakage of bowel content – due to damage or breakdown of tissue at the area where the bowel was severed
Infection – can occur in the wound(s), lungs, drip site or at the location where the operation took place along the bowel
Deep vein thrombosis – blood clots forming in the deep veins can occur with any surgery
Damage to surrounding structures – nearby structures can be damaged inadvertently although all efforts are made to prevent such damage
Reversal of Stoma: Bleeding, infection (intra-abdominal abscess, urinary and wound infection), unintentional perforation of the bowel, leak at the site where bowels are reconnected, an abnormal opening between the bowel and the skin, paralysis temporary or permanent of the intestines, a narrowing at the site where the bowels are reconnected, reoperation.

Duration:

N/A