Temporary loop ileostomy or permanent end colostomy for low rectal cancer: making the right choice

Author:

Skipper Gill1

Affiliation:

1. Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, Norfolk

Abstract

Low rectal cancer is treated by surgical removal of part of the colon via abdominoperineal resection (APR), ultra-low Hartmann's (ULH) or low anterior resection (LAR), followed by stoma formation. APR and ULH always result in a permanent end colostomy. LAR usually results in anastomosis with a defunctioning loop ileostomy, which can be reversed to restore mostly normal bowel function, making it the procedure of choice. A stoma can be difficult to manage, getting more so with age or infirmity, and complications are frequent, so a temporary stoma is generally preferable for a patient's wellbeing. However, a loop ileostomy is usually more problematic than a permanent colostomy, with greater chance of high output. Meanwhile, reversal surgery is not guaranteed, carries some risk and often results in reduced bowel function. The colorectal multidisciplinary team (MDT) and, in elective surgery, the patient, must decide which is the most appropriate option. The stoma care nurse (SCN) has a vital role in providing pre-operative assessment, supporting informed decision making and siting the stoma, as well as postoperative follow up and support up to and following stoma reversal.

Publisher

Mark Allen Group

Subject

Advanced and Specialised Nursing,Medical–Surgical

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Gastrointestinal Surgery;Stoma Care Specialist Nursing: A Guide for Clinical Practice;2023

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