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Clin Colon Rectal Surg 2017; 30(03): 172-177
DOI: 10.1055/s-0037-1598157
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Considerations in Stoma Reversal

Karen L. Sherman
1   Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
,
Steven D. Wexner
1   Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida
› Author Affiliations
Further Information

Publication History

Publication Date:
22 May 2017 (online)

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Abstract

Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection. Furthermore, many stomas, which were intended to be temporary, may not be reversed due to postoperative complications, adjuvant therapy, or prohibitive comorbidities.

Keywords

stoma - ileostomy closure - Hartmann's reversal - colostomy closure
 

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