Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Society of Colon and Rectal Surgeons.

Ostomy Surgery

American Society of Colon and Rectal Surgeons

Publication Date: May 24, 2022

Page Last Updated: May 5, 2026

The GRADE system: grading recommendations

Grade	Description	Benefit vs. risk and burdens	Quality of supporting evidence	Implications
1A	Strong recommendation, High-quality evidence	Benefits clearly outweigh risk and burdens or vice versa	RCTs without important limitations or overwhelming evidence from observational studies	Strong recommendation, can apply to most patients in most circumstances without reservation
1B	Strong recommendation, Moderate-quality evidence	Benefits clearly outweigh risk and burdens or vice versa	RCTs with important limitations (inconsistent results, methodologic flaws, indirect or imprecise) or exceptionally strong evidence from observational studies	Strong recommendation, can apply to most patients in most circumstances without reservation
1C	Strong recommendation, Low- or very-low quality evidence	Benefits clearly outweigh risk and burdens or vice versa	Observational studies or case series	Strong recommendation but may change when higherquality evidence becomes available
2A	Weak recommendation, High-quality evidence	Benefits closely balanced with risks and burdens	RCTs without important limitations or overwhelming evidence from observational studies	Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
2B	Weak recommendations, Moderate-quality evidence	Benefits closely balanced with risks and burdens	RCTs with important limitations (inconsistent results, methodologic flaws, indirect or imprecise) or exceptionally strong evidence from observational studies	Weak recommendation, best action may differ depending on circumstances or patients’ or societal values
2C	Weak recommendation, Low- or very-low quality evidence	Uncertainty in the estimates of benefits, risks and burden; benefits, risk, and burden may be closely balanced	Observational studies or case series	Very weak recommendations; other alternatives may be equally reasonable

Document Overview

Document Title: Ostomy Surgery

Authoring Society: American Society of Colon and Rectal Surgeons

Document Publication Date: May 24, 2022

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journals.lww.com/dcrjournal/Fulltext/2022/10000/The_American_Society_of_Colon_and_Rectal_Surgeons.5.aspx

Source Citation: Davis BR, Valente MA, Goldberg JE, Lightner AL, Feingold DL, Paquette IM; Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery. Dis Colon Rectum. 2022 Oct 1;65(10):1173-1190. doi: 10.1097/DCR.0000000000002498. Epub 2022 May 24. PMID: 35616386.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: Give guidance to surgeons and other health care providers in an effort to improve the quality of care and outcomes for patients undergoing ostomy surgery.

Scope: Management, Prevention

Diseases/Conditions (MeSH)

D003107 - Colorectal Surgery

D010030 - Ostomy

D003107 - Colorectal Surgery

D010030 - Ostomy

Keywords: ostomy surgery, parastomal hernia

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Infant, Older Adult

Health Care Settings: Emergency Care, Hospital, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 205

Literature Search Start Date: Wednesday, January 1, 2014

Literature Search End Date: Wednesday, December 1, 2021

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Ostomy Surgery

Recommendations

OSTOMY CREATION

OSTOMY CLOSURE

OSTOMY COMPLICATIONS

EVIDENCE FOR THE VALUE OF AN OSTOMY NURSE

The GRADE system: grading recommendations

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology