Construction of Intestinal Stomas

Abstract

Despite intense medical treatment, for most patients with Crohn’s disease surgery will eventually become necessary. It has been shown that 75% of all patients with Crohn’s disease will eventually undergo an operation on some area of their intestinal tract (1–5). A major concern of the surgeon is to preserve as much of the intestinal tract as possible since intestinal resection is pallative for patients with Crohn’s disease. Therefore, the goal of surgery is to perform targeted and limited resections to alleviate the clinical symptoms and complications of Crohn’s disease (4). In this context, it frequently becomes necessary to create a temporary or permanent intestinal stoma. The creation and management of end and loop intestinal stomas requires special attention by the surgeon and other members of the healthcare team to avoid complications and to allow patients to return to an active lifestyle. Pieper (6) and others report that people with newly constructed intestinal stomas have many concerns about resuming their previous lifestyle, including household activities, sexual function, and leisure activities. In this chapter the indications, surgical techniques, management and complications of end and loop stomas in patients with Crohn’s disease will be reviewed.