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Ostomy Surgery
Publication Date: May 24, 2022
Last Updated: January 2, 2023
Recommendations
OSTOMY CREATION
When feasible, laparoscopic ostomy formation is preferred to ostomy formation via laparotomy. (1C)
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Loop ileostomy is preferred over transverse loop colostomy for temporary fecal diversion in most cases. (2B)
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Whenever possible, both ileostomies and colostomies should be fashioned to protrude above the skin surface. (1C)
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When using a support rod for a loop ostomy, a flexible or rigid ostomy rod may be used. (2C)
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Use of antiadhesion materials may be considered to decrease adhesions at temporary ostomy sites. (2B)
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Lightweight polypropylene mesh may be placed at the time of permanent ostomy creation to decrease parastomal hernia rates. (1B)
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Extraperitoneal tunneling of end colostomies may decrease parastomal hernia rates. (2C)
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For patients with a new ileostomy, postoperative care pathways may prevent hospital readmission for dehydration. (1C)