WordNet

a surgical operation that creates an opening from the colon to the surface of the body to function as an anus
a minute epidermal pore in a leaf or stem through which gases and water vapor can pass (同)stomate, pore
a mouth or mouthlike opening (especially one created by surgery on the surface of the body to create an opening to an internal organ)

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結腸人工肛門造設術
気孔(葉・茎の表皮にあって気体の出入りに役立つ小さな穴)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/17 16:00:00」(JST)

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A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. It may be reversible or irreversible depending on the circumstances.

Indications

There are many reasons for this procedure. Some common reasons are:

A section of the colon has been removed, e.g. due to colon cancer requiring a total mesorectal excision, diverticulitis, injury, etc., so that it is no longer possible for feces to exit via the anus.
A portion of the colon (or large intestine) has been operated upon and needs to be 'rested' until it is healed. In this case the colostomy is often temporary and is usually reversed at a later date, leaving the patient with a small scar in place of the stoma. Children undergoing surgery for extensive pelvic tumors commonly are given a colostomy in preparation for surgery to remove the tumor, followed by reversal of the colostomy.
Fecal incontinence that is non-responsive to other treatments.

Options

Illustration depicting various types of colostomy

Placement of the stoma on the abdomen can occur at any location along the colon, but the most common placement is on the lower left side near the sigmoid where a majority of colon cancers occur. Other locations include the ascending, transverse, and descending sections of the colon.^[1]

Types of colostomy:^[2]^[3]

Loop colostomy: This type of colostomy is usually used in emergencies and is a temporary and large stoma. A loop of the bowel is pulled out onto the abdomen and held in place with an external device. The bowel is then sutured to the abdomen and two openings are created in the one stoma: one for stool and the other for mucus.
End colostomy: A stoma is created from one end of the bowel. The other portion of the bowel is either removed or sewn shut (Hartmann's procedure).
Double barrel colostomy: The bowel is severed and both ends are brought out onto the abdomen. Only the proximal stoma is functioning.

Colostomy surgery that is pre-planned usually has a higher rate of long-term success than surgery performed in an emergency situation.^{[citation needed]}

People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed a couple of times a day depending on the frequency of activity; in general the further from the anus (i.e., the further 'up' the intestinal tract) the ostomy is located the greater the output and more frequent the need to empty or change the pouch.^[4]

Colostomy with irrigation

People with colostomies who have ostomies of the sigmoid colon or descending colon may have the option of irrigation, which allows for the person to not wear a pouch, but rather just a gauze cap over the stoma, and to schedule irrigation for times that are convenient.^[5] To irrigate, a catheter is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve.^[6] Most colostomates irrigate once a day or every other day, though this depends on the person, their food intake, and their health.

Alternatives

A UK man has been given a remote-controlled bowel.^[7] Colostomy or ileostomy is now rarely performed for rectal cancer, with surgeons usually preferring primary resection and internal anastomosis,^[8] e.g. an ileo-anal pouch. In place of an external appliance, an internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to act as a new rectum to replace the removed original.

References

^ Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada.p1393
^ Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada. p1393-1394
^ http://oncolex.org/en/Colorectal%20cancer/Procedures/TREATMENT/Surgery/Anleggelse%20av%20stomi?lg=procedure
^ "Colostomy irrigation: Colostomy Guide". United Ostomy Associations of America. Retrieved 4 February 2013.
^ Rooney, Debra. "Colostomy irrigation: A personal account managing colostomy". Ostomy. Retrieved 7 September 2012.
^ Wax, Arnold. "What is colostomy irrigation?". WebMed. Retrieved 7 September 2012.
^ Man-uses-remote-to-control-his-bionic-bottom The Telegraph]
^ al.], senior editors, Bruce G. Wolff ... [et (2007). The ASCRS textbook of colon and rectal surgery. New York: Springer. p. 417. ISBN 0-387-24846-3.

UpToDate Contents

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1. Routine care of patients with an ileostomy or colostomy and management of ostomy complications
2. ストーマ造設術の外科的原則 surgical principles of ostomy construction
3. 大腸切除術の吻合部合併症のマネージメント management of anastomotic complications of colorectal surgery
4. 腹会陰式直腸切断術（APR）：開腹術 abdominal perineal resection apr open technique
5. 直腸腟瘻、肛門腟瘻、および結腸膀胱瘻 rectovaginal anovaginal and colovesical fistulas

English Journal

Sevelamer crystals in the mucosa of the gastrointestinal tract in a teenager with end-stage renal disease.

Kim J1, Olson K1, Butani L2.
Pediatric nephrology (Berlin, Germany).Pediatr Nephrol.2016 Feb;31(2):339-41. doi: 10.1007/s00467-015-3269-1. Epub 2015 Nov 13.
BACKGROUND: Non-calcium-containing phosphate binders, such as sevelamer preparations, are being increasingly used in patients on dialysis due to their lower association with hypercalcemia and cardiovascular morbidity and mortality. While minor gastrointestinal side effects are quite common with the
PMID 26563116

Stoma-related symptoms in patients operated for rectal cancer with abdominoperineal excision.

Marinez AC1, González E2, Holm K2, Bock D2, Prytz M2,3, Haglind E2, Angenete E2.
International journal of colorectal disease.Int J Colorectal Dis.2016 Jan 5. [Epub ahead of print]
PURPOSE: The primary aim of this study was to characterize the frequency, severity, and distress of symptoms from the colostomy and colostomy acceptance in rectal cancer patients. The secondary aims were to study the symptomatic parastomal herniation, its relationship to stoma-related symptoms, and
PMID 26728024

Ileostomy and colostomy occlusion with digital tampon during laparotomy.

Boyd K1, Copertino N1, Lambrianides AL1.
Annals of the Royal College of Surgeons of England.Ann R Coll Surg Engl.2016 Jan;98(1):72. doi: 10.1308/rcsann.2016.0017.
PMID 26688412