In the context of colorectal surgery, stomas of the large intestine are often created on the abdominal wall at various sites.
They may be performed electively or as emergency procedures.
The most common conditions requiring colostomy formation include:
• Colorectal malignancies
• Diverticulitis
• Abdominal trauma involving penetrating injuries
• Endometriosis of the rectum (less common)
In planned operations, a colostomy may be created as part of the operative sequence of a laparoscopic colectomy.
Colostomies may be permanent or temporary.
Permanent Colostomies
These remain lifelong and are performed following the decision of the responsible surgeon.
Temporary Colostomies
These remain in place for a short therapeutic interval (1–3 months) and are performed following the decision of the responsible surgeon.
Closure (reversal) of the colostomy is carried out via open surgery or laparoscopically (associated with reduced patient burden).
During the period in which a colostomy is present, specialised stoma bags are applied to the skin at the site of the stoma for the collection of intestinal output.
Specialist stoma care nurses provide training and support to patients and their families on the correct placement and management of colostomy bags.
At present, colostomy bags are supplied following prescription by the treating physician.
The decision to create a colostomy understandably carries psychological impact for patients.
However, with appropriate support from medical and allied health professionals, the colostomy becomes an integrated and manageable part of the patient’s life.
