What is stoma?
stoma (Greek =mouth) is an artificial union made between 2
conduits (eg- a choledochojejunostomy) or, more commonly, between a
conduit and the outside -eg a colostomy, in which faeces are made
to pass through a hole in the abdominal wall into an adherent plastic bag,
ideally as 1-2 formed motions/day.
Types of
stoma?
- Loop colostomy: A loop of colon is exteriorized, opened, and
sewn to the skin. A rod under
the loop prevents retraction and may be removed after 7d. This can be a defunctioning stoma (below), though faeces may pass beyond the
loop. It is often temporary, and more prone
to complications than end colostomies.
- End colostomy: The bowel is divided; the proximal
end brought out as a stoma; the distal
end may be:
- resected, eg abdominoperineal resection;
- closed & left in the abdomen (Hartman's procedure);
- exteriorized, forming a mucous fistula
- Double-barrelled (Paul-Mikulicz) colostomy: The
colon is brought out as a double-barrel.
It may be closed using an enterotome.
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