Background
Surgical stomas are constructed to connect a body cavity to the outside and are named according to their anatomic location—for example, colostomy, ileostomy, or urostomy. A colostomy is a surgical procedure by which a stoma is constructed through exteriorization of the large intestine.
A colostomy can be constructed as a loop colostomy or as an end colostomy. A loop colostomy is defined as a stoma in which the entire loop of colon is exteriorized and both the proximal limb and the distal limb open into the common stoma opening and are not transected. An end colostomy is created from the proximal end of the colon; the distal end can be stapled or sewn shut and remains as a blind pouch, or it can be exteriorized separately.
This article focuses on the surgical techniques for constructing a loop colostomy.
Indications
Loop colostomies are usually temporary and are generally constructed in preference to end colostomies whenever the colostomy is intended to be reversed at a later date. Compared with takedown of an end colostomy, local takedown of a loop colostomy is associated with a shorter average hospital stay, less intraoperative blood loss, and a lower complication rate. [1]
The main indications for loop colostomies are as follows:
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To relieve distal obstruction [2] (mainly as a palliative procedure)—for example, in the case of obstructing rectal cancer [3, 4]
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To divert fecal load from a newly performed distal anastomosis
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Construction of loop colostomy.
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Construction of loop colostomy.
