COLOSTOMY CREATION, REVERSAL AND CARE
At a glance
A colostomy is a procedure that entails making an opening through the abdomen for the repositioning of the colon. The placement of a colostomy bag may be temporary or permanent. First, the colon is rearranged via the abdominal wall where it is inverted, similar to a cuff. Next, Dr Maraj attaches the sides of the colon to the abdominal region, creating an opening, also known as a stoma. It is through the stoma whereby stool can flow into the colostomy bag attached from the outside.
You may require a colostomy bag should you develop inflammatory bowel disease (IBD), diverticulitis, a bowel obstruction, colon or rectal injury, perianal fistula or a condition more serious such as colon cancer. Placing a colostomy bag may only be a temporary solution for conditions that affect the bowels. Dr Maraj will advise whether a colostomy reversal will be best suited to you. The part and length of the colon that remains determines the surgical reversal of the colostomy.
A colostomy reversal is a viable option at least six months after the initial procedure when:
- You are fit enough to undergo surgery.
- An adequate supply of the remaining healthy colon and rectum are sufficient to function.
- You have healthy bowels and a strong anal sphincter
- You have met the necessary nutritional requirements
- You have been evaluated by additional investigations, which may include blood tests, a CT scan, MRI and colonoscopy.
How to prepare for the procedure
Before placing a colostomy bag, consider talking to your doctor about surgery and post-operative care. Also, join an ostomy support group regarding life after surgery and caring for the bag in the future.
A dietician will be part of your care team who advises on your nutritional needs.
What the procedure involves
Dr Maraj rearranges your large intestine (colon) and joins it to an abdominal opening (stoma) for stool to exit through into an external colostomy bag. There are two ways to carry out a colostomy; the first is through less invasive surgery, whereas a laparoscope is made use of while the other is via open surgery.
What to expect post-procedure
After the procedure, you will be monitored in the hospital. Getting used to the bag is not easy, but given the time, you will be more comfortable wearing a colostomy bag. Of course, maintenance is essential, so changing the pouches prevents irritation of the skin. Also, cleaning the region near the stoma using sterile water reduces the risk of skin trouble.
Nursing staff will teach you how to change and care for your bag. A dietician and physiotherapist will be part of the team. This is merely a basic guide; Dr Maraj will be able to provide you with further information should you need it.
Risks & complications
Guidelines and protocols are followed to prevent complications, and you will be closely monitored for complications such as bleeding, infection of the wound, abdomen, pelvis, chest, urine, as well as an anastomotic leak. In addition, other complications include deep vein thrombosis and pulmonary embolism or side effects due to the anaesthetic used. These will be appropriately treated and may require hospitalisation and further intervention.
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