The Plight of the Ostomate

Michael F. McGee, MD, FACS, FASCRS

Simply put, there may be no bigger fear to the colorectal surgery patient than fear of “the bag.”

Yet, surgeons know that a stoma facilitates at least cure for many disease processes, can mitigate life-threatening complications, and, in many cases, improve a patient's quality of life. So, how can such a disconnect between patient and surgeon exist? Why would patients “rather die than have a bag”? This paradox was the impetus behind this issue of Clinics in Colon and Rectal Surgery, and one of my personal clinical and research interests.

The stoma is the ultimate patient dissatisfier and can drive up length of stay, readmissions, and complications—and exact even higher rates of intangibles such as patient anxiety, cost, and frustration. This issue was built to better arm surgical care teams with resources to help ostomates live a high-quality life. From preoperative planning and patient activation to technical considerations of operative construction and reversal, and management of common complications (and even risqué topics such as sexuality), this issue was built to give surgeons pragmatic, practice-ready advice on how to help patients who are experiencing probably the most life-altering event they will ever face.

I would like to thank each author for providing eloquent expertise on how to handle each aspect of stoma care. The authors—surgeons, stoma care nurses, therapists, and patients—are passionate about their cause and represent thought leaders in their respective content area. Lastly, I am wholeheartedly appreciative and thankful to the Clinics in Colon and Rectal Surgery editorial staff, particularly Dr. Scott Steele, for sharing the vision and passion for the plight of the ostomate.