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