About the colorectal stoma

What is the role of the colon?

The large intestine (colon) is the section of the digestive tract between the small intestines and the rectum, which is located in an inverted U shape in the abdomen. This is the final stage of digestion, the reabsorption of water and the exchange of ions, and is where the formed faeces are formed and passed out through the rectum, the final outlet of the large intestine.

What is a colorectal stoma and what is the stoma reconstruction (colonic reconstruction)?

In which cases is a stoma formed?

  • inflammation of the colon
  • a benign or malignant tumour
  • benign inflammatory disease

If your doctor or medical team decides, the ostomy may be closed.

How is the stoma closed?

During open surgery, the stoma is dissected through the previous incision and the continuity of the colon is restored with sutures.

Why should the intervention be carried out?

After the stoma of the large intestine closes, faeces can be passed through the anus instead of the external orifice. This avoids all complications associated with colostomy (hernia, prolapse, stricture, haemorrhage, local inflammation of the skin surface).

How to prepare for surgery?

You will most likely arrive the day before your operation. One to two weeks before the planned day of surgery, we will carry out the necessary check-ups, which may include laboratory tests, ECG, X-rays and, if necessary, anaesthesia.

Colonoscopies may require complete emptying of the colon and rectum, and your surgeon may ask you to follow a fluid diet for a few days before the operation, and you may also need to take a stool softener or enema before the operation. Your surgeon will give you detailed advice on this.

How is the surgery done?

The surgery is performed under general anaesthesia, and the abdominal cavity is accessed through the previous skin incision. The adhesions in the abdomen are dissolved, and in the case of a terminal stoma, the blindly closed intestinal end is approached. If the surgical situation so requires, a silicone tube (drain) is temporarily left in the abdominal cavity to drain any blood clots or bleeding.

Are there other treatment options?

There is no alternative.

Potential complications of surgery

Haemorrhage, vascular haemorrhage, separation of intestinal sutures, infection of abdominal wound, fistula formation, skin around the scar may become numb (usually resolves within 2-3 months), deep vein thrombosis.

How long do I have to stay in hospital?

We usually discharge you 3-5 days after the operation.

Will I have pain after the operation?

During the operation, you will sleep and feel no pain. Upon waking, you can expect to experience some discomfort, and we will do our best to minimise this, or if it has developed, to alleviate it. The incision may be painful after the operation, and the wound will be anaesthetised as a final step in the operation.

The recovery period

The operation involves inserting an intravenous cannula, a bladder catheter and a stomach tube, which is passed through the nose. These devices are expected to be removed within 1-3 days after surgery.

After partial removal of the colon, it is normal to feel weaker and more tired for up to weeks, but you should usually return to normal activity within 6-8 weeks. It is important that you follow the diet recommended by your doctor at home and gradually increase your exercise.

Exercise:

You will feel more fatigued in the few weeks after surgery and a gradual return to daily activity is recommended. For the first 6-8 weeks, avoid heavy physical work, lifting weights and intense sports activities.

Work:

Return to work depends on the type of work and the extent of the surgery. Expect to return to work within 1-2 weeks.

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