Indications
The indications for stoma formation may be divided up according to required function:
- feeding:
- enteral route is preferred to parenteral
- may be initiated pre-/peri-/postoperatively
- common site is the gastrostomy or jejunostomy
- decompression:
- can be performed at any point in the gastrointestinal tract
- usually temporary
- may be used for diversion of a faecal stream when a distal anastomosis is at risk from leakage
- lavage:
- usually a temporary caecostomy is used for on-table lavage before resecting distal colonic disease
- exteriorization of bowel:
- for when bowel resection with primary anastomosis is hazardous
- makes the treatment of colonic trauma, perforation, ischaemia and obstruction much safer
- permanent stomas:
- after panproctocolectomy an ileostomy is formed
- after abdominoperineal excision of the rectum, a colostomy is formed
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