Plasencia A, Bahna H, et al.
Clinics in colon and rectal surgery. Date of publication 2019 May 1;volume 32(3):171-175.
1. Clin Colon Rectal Surg. 2019 May;32(3):171-175. doi: 10.1055/s-0038-1677004. Epub
2019 Apr 2.
Diverting Ostomy: For Whom, When, What, Where, and Why.
Plasencia A(1), Bahna H(2)(3).
Author information:
(1)Jackson Memorial Hospital, University of Miami, Miami, Florida.
(2)Division of Colon and Rectal Surgery, DeWitt Daughtry Family Department of
Surgery, Miller School of Medicine, University of Miami, Miami, Florida.
(3)University of Miami at JFK Medical Center, Atlantis, Florida.
Fecal diversion is an important tool in the surgical armamentarium. There is much
controversy regarding which clinical scenarios warrant diversion. Throughout this
article, we have analyzed the most recent literature and discussed the most
common applications for the use of a diverting stoma. These include construction
of diverting ileostomy or colostomy, ostomy for low colorectal/coloanal
anastomosis, inflammatory bowel disease, diverticular disease, and obstructing
colorectal cancer. We conclude the following: diverting loop ileostomy is
preferred to loop colostomy, an ostomy should be used for a pelvic
anastomosis < 5 to 6 cm including coloanal anastomosis and ileo-anal-pouch
anastomosis, severe perianal Crohn's disease frequently requires diversion, a
primary anastomosis with diverting ileostomy in the setting of diverticular
perforation is safe, and a diverting stoma can be used as a bridge to primary
resection in the setting of an obstructing malignancy.
DOI: 10.1055/s-0038-1677004
PMCID: PMC6500738 [Available on 2020-05-01]
PMID: 31061646
