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Colostomy

An operation that attaches the colon to an opening in the abdomen called a stoma. An ostomy pouch, attached to the stoma and worn outside the body, collects stool. A temporary colostomy may be created to allow the rectum to heal from injury or surgery.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

What works? Research summarized

Evidence reviews

Covering ileo‐ or colostomy in anterior resection for rectal carcinoma is associated with less anastomotic leakage, but does not offer advantage in term of 30 days or long term mortality.

Anastomotic leak is a breakdown of a suture line in a surgical anastomosis with a consequent leakage of intestinal fluid, following surgical intervention. Anastomotic leak is one the most significant complications that occur after performing a surgical intervention for rectal cancer. Anastomotic leak may increase morbidity, mortality and the duration of hospital stay. Use of a covering stoma may prevent the occurrence of anastomotic leak. This review assessed 6 randomised trials and found that the rate of anastomotic leak is significantly lower with the use of a covering stoma. However, there is no evidence that mortality can be reduced by using a covering stoma.

Ileostomy or colostomy for temporary decompression of colorectal anastomosis

Anastomotic leakage after left‐sided colorectal resections is a serious complication, which leads to increase morbidity and mortality and prolonged the hospital stay. Proximal fecal diversion may limit the consequences of anastomotic failure. It remains controversial whether a loop ileostomy or a loop transverse colostomy is a better form of fecal diversion. This review included five randomised trials (334 patients), comparing loop ileostomy (168 patients) and loop colostomy (166 patients) used to decompression of a colorectal anastomosis. Except for stoma prolapse, none of the reported outcomes reported were statistically or clinically significant. Continuous outcomes, such as lenght of hospital stay, was not included due to insufficient data reported in the primary studies.

Temporary ileostomy versus temporary colostomy: a meta-analysis of complications

OBJECTIVE: To compare the complications of temporary diverting ileostomy with those of temporary colostomy for patients with colorectal diseases.

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Summaries for consumers

Covering ileo‐ or colostomy in anterior resection for rectal carcinoma is associated with less anastomotic leakage, but does not offer advantage in term of 30 days or long term mortality.

Anastomotic leak is a breakdown of a suture line in a surgical anastomosis with a consequent leakage of intestinal fluid, following surgical intervention. Anastomotic leak is one the most significant complications that occur after performing a surgical intervention for rectal cancer. Anastomotic leak may increase morbidity, mortality and the duration of hospital stay. Use of a covering stoma may prevent the occurrence of anastomotic leak. This review assessed 6 randomised trials and found that the rate of anastomotic leak is significantly lower with the use of a covering stoma. However, there is no evidence that mortality can be reduced by using a covering stoma.

Ileostomy or colostomy for temporary decompression of colorectal anastomosis

Anastomotic leakage after left‐sided colorectal resections is a serious complication, which leads to increase morbidity and mortality and prolonged the hospital stay. Proximal fecal diversion may limit the consequences of anastomotic failure. It remains controversial whether a loop ileostomy or a loop transverse colostomy is a better form of fecal diversion. This review included five randomised trials (334 patients), comparing loop ileostomy (168 patients) and loop colostomy (166 patients) used to decompression of a colorectal anastomosis. Except for stoma prolapse, none of the reported outcomes reported were statistically or clinically significant. Continuous outcomes, such as lenght of hospital stay, was not included due to insufficient data reported in the primary studies.

No apparent differences in quality of life are found in rectal cancer patients with a permanent stoma when compared to non‐stoma patients.

For patients diagnosed with rectal cancer, surgery is the definite treatment. The surgical outcome is either restored bowel continuity, or the formation of a stoma. Traditionally the formation of a colostomy has been regarded as an unfavourable outcome, as the quality of life of stoma patients is believed to be inferior compared to that in non‐stoma patients. The included studies in this review do not support this assumption, although firm conclusions cannot be drawn.

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More about Colostomy

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Other terms to know:
Rectum, Stoma

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