Colostomy and Ilestomy: Therapeutic Strategy?
DOI:
https://doi.org/10.14738/bjhr.1206.19669Keywords:
Colostomy, Ileostomy, Stoma, Medical colostomy, Surgery, Coloproctology, peristomal hernia, ProlapseAbstract
Introduction: Colostomy and/or ileostomy is an opening in the abdomen by means of a surgical intervention, with the function of evacuating fecal matter or gastrointestinal waste. Objective: To describe the experience in public hospitals when performing colostomy and ileostomy surgeries on patients. Method: A multicenter study with a retrospective, longitudinal, observational and descriptive design of the Surgery and Coloproctology Service, a study of five second and third level health care hospitals in Mexico City and the State of Mexico. Results: Of 1,693 cases, a total of 91 patients with intestinal stomas exclusively were documented, with complete records/files of a distribution by sex of 47 men representing 51.64% and 44 women representing 48.35%. With an average age of 44 years and range from 21 to 95 years. The most frequent etiologic diagnosis for creating a stoma is complicated acute appendicitis. In specific pathologies, where other surgeons perform a stoma, the authors of this study perform the medical colostomy strategy. Discussion: When is an ileostomy performed? This decision must be considered in true medical situations. Preventive ileostomy has unique excretion characteristics: aqueous, highly alkaline deposition with proteolytic enzymes. The initial daily stool volume in the new ostomy is approximately 1200 ml, and after a period of bowel adaptation, it remains between 500- and 800-ml. Short-term complications may include stoma retraction, necrosis, high-output stoma, and obstruction of the stoma orifice; long-term complications include stoma prolapse, strictures, skin irritation, and peristomal hernia. Conclusions: Ileostomy and/or colostomy are therapeutic arsenals that, if well indicated or justified, are a timeless benefit or asynchronism when created, impacting the life of the patient in an emergency or programmed by the underlying disease. The controversy of the current surgical conduct of performing a stoma of the small intestine or colon is condemnatory by the surgical community, however, it is still a saving, timely or excellent strategy, depending on the context of each patient.
References
Castejón MG. Colosotmias. EEV. MED. Hondur 1975; 43: 106-114.
Haeger K. Historia de la Cirugía. Corporativo Intermédica, 1999.
Duret C, Quoted-Dinnick T. The origins and evolution of colostomy. Br J Surg 1934; 22: 142-154
Corman ML, Odenhermer BD. Securing the loop historic review of the methods used creating loop colostomy. Dis Colon Rectum 1991; 34:1014-1020.
Amussat JZ. Mémoire sur la possibilité d`étabilir un anus artificiel dans la région lombaire sans pénétrer dans le péritoine. Paris: Germer-Baillère, 1839 (traducido al inglés en Dis Colon Rectum 1983; 26: 483-487).
Maydi K. Zur technik del kolostomie, Centralblatt. Chirg 1888; 15: 433-440.
Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and the terminal portion of the pelvic coloon. Lacnert 1908: 2: 1812.
Verkuijl SJ, Jonker JE, Furnée EJB, Kelder W, Hoff C, Hess DA, Wit F, Zijlstra RJ, Trzpis M, Broens PMA. The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer. Dis Colon Rectum. 2024 Feb 1;67(2):291-301. doi: 10.1097/DCR.0000000000003009.
American Cancer Society. cancer.org | 1.800.227.2345. Revisado en: https://www.cancer.org/es/cancer/como-sobrellevar-el-cancer/tipos-detratamiento/cirugia/ostomias/colostomia/tipos-de-colostomias.html
Hernández, J. L. G., Cabello, J. de J. U., Barrón, G. M., Suárez, I. A. L., Segura, C. A. S., Medina, M. S. H., & Sánchez, M. A. G. (2025). Medical Colostomy: A New Resource. British Journal of Healthcare and Medical Research, Vol - 12(04). 43-58. DOI:10.14738/bjhr.1204.19092.
Li X, Liu X, Deng X, Zhang H, Su J, Yuan L, Zhou A. Latent profiles and influencing factors of quality of life among patients with colorectal cancer and an enterostomy in Southwest China: A multicenter cross-sectional study. Asia Pac J Oncol Nurs. 2025 Jun 18; 12:100745. doi: 10.1016/j.apjon.2025.100745.
Ko H., Wu M., Lu J. Estudio controlado aleatorizado: efectividad de la educación multimedia en el autocuidado y la calidad de vida de pacientes con enterostomía. Int Wound J. 2023; 20(10):4244–4252. doi: 10.1111/iwj.14326.
Hao J, Xu Y, Li H. The Value of Applying a Continuous Nursing Model Based on Virtual Platforms for Patients with Colostomy or Ileostomy. Adv Skin Wound Care. 2023 Apr 1;36(4):206-212. doi: 10.1097/01.ASW.0000919960.94295.53.
Morelos Adolfo García Sánchez., et al. “Colon Cancer and Rectum. A Critical Problem in Mexico”. EC Gastroenterology and Digestive System 8.4 (2021): 104-116.
Abdelmohsen SA. Effectiveness of Structured Education on Patient's Knowledge and Practice Regarding Colostomy Care. Asia Pac J Oncol Nurs. 2020 Sep 14;7(4):370-374. doi: 10.4103/apjon.apjon_24_20.
Jin Y, Ma H, Jiménez-Herrera M. Self-disgust and stigma both mediate the relationship between stoma acceptance and stoma care self-efficacy. J Adv Nurs. 2020 Oct;76(10):2547-2558. doi: 10.1111/jan.14457.
Bian L, Jullamate P, Toonsiri C, Suksawang P. Self-care and associated factors of patients with permanent colostomies: A structural equation model. Asia Pac J Oncol Nurs. 2025 Feb 13;12:100666. doi: 10.1016/j.apjon.2025.100666. 126
Igarashi T, Tominaga K, Kojima Y, Nakamura M, Tonouchi T, Takeda N, Yoshida T, Kawata Y, Sakamaki A, Terai S. A rare case of ulcerative colitis relapse in a diverted colon after rectal cancer surgery: efficacy of carotegrast methyl. Clin J Gastroenterol. 2025 Nov 6. doi: 10.1007/s12328-025-02243-7.
McMahon RK, O'Cathail SM, Steele CW, Nair HS, Platt JJ, McMillan DC, Horgan PG, Roxburgh CS. Circulating Markers of Systemic Inflammation, Measured After Completion of Neoadjuvant Therapy, Associated With Response in Locally Advanced Rectal Cancer. Dis Colon Rectum. 2025 Jun 1;68(6):713-725. doi: 10.1097/DCR.0000000000003660.
Björklund Sand L, Larsson C, Grönkvist R, Haglind E, Angenete E. Persistent Sitting and Walking Difficulties After Abdominoperineal Excision and Anterior Resection: Results From the Quality of Life in Rectal Cancer Study. Dis Colon Rectum. 2025 Jun 1;68(6):704-712. doi: 10.1097/DCR.0000000000003710.
Rutegård M, Svensson J, Segelman J, Matthiessen P, Lydrup ML, Park JM; RectoLeak Study Group. Anastomotic Leakage in Relation to Type of Mesorectal Excision and Defunctioning Stoma Use in Anterior Resection for Rectal Cancer. Dis Colon Rectum. 2024 Mar 1;67(3):398-405. doi: 10.1097/DCR.0000000000003050.
Burghgraef TA, Bakker IS, Veld JV, Wijsmuller AR, Amelung FJ, Bemelman WA, Ter Borg F, van Hooft JE, Siersema PD, Tanis PJ, Consten ECJ; Dutch Snapshot Research Group. Predicting Mortality Within 90 Days of First Intervention in Patients With Left-Sided Obstructive Colon Cancer. Dis Colon Rectum. 2023 Oct 1;66(10):1309-1318.
Hernández, J. L. G., Cabello, J. J. U., Alva, M. L. A. C., Suárez, I. A. L., Barrón, G. M., & Sánchez, M. A. G. (2025). Recurrent Bowel Obstruction: Is it a Disease? Or a Sign? What is its Treatment? British Journal of Healthcare and Medical Research, Vol - 12(05). 46-61.
Ricardo, L. G. B., Adolfo, G. S. M., Atzimba, Z. C. C., Astrid, O. V., Montserrat, H. M. J., de Jesús, U. C. J., Rogelio, O. R. M., Gema, M. B., Mariana, G. V., Itzel, L. G. E., & Antonio, M. R. D. (2024). Open Abdomen Is the Equal of Catastrophic or Hostile? British Journalof Healthcare and Medical Research, Vol - 11(2). 182-200.
Adolfo, G. S. M., Mireya, D. L. F. G., Gema, M. B., Isabel, E. R. M., Israel, F. P. M., Astrid, O. V., Yamileth, J. B., Giselle, C. G., Beatriz, L. G. H., Sofia, H. M. M., Jessica, B. N., Sergio, F. Z., Salvador, Z. C. E., & Enrique, M. M. C. (2023). Pseudodiverticular Colon Disease:A Therapeutic Challenge. British Journal of Healthcare and Medical Research, Vol - 10(5). 197-211
Itami K, Yoshikawa T, Mori T, Kajimoto K, Yazumi S. Endoscopic submucosal dissection for early cancer using the water pressure method in the remnant rectum after Hartmann's procedure. Endoscopy. 2025 Dec;57(S 01): E1074-E1075. doi: 10.1055/a-2690-1982.
Sánchez, M. A. G., Hernández, J. L. G., Cabello, J. de J. U., Barrón, G. M., Castillo, L. F. F., Salvador, J. R. H., Suárez, I. A. L., Daniel, M.Y. P., & Oca Ambriz, I. R. M. (2025). Damage Control Surgery: A Strategic Resource! British Journal of Healthcare and Medical Research, Vol - 12(02). 90-109.
Martínez, B. Z. A., Jarquin, J. L., Piña, O. E., Ocampo, C. I. C., Sánchez, U. S. C., Guerrero, L. G., Ángeles,B. P. R., & Sánchez, M. A. G. (2025). Colon Volvulus: Disease or Consequence? British Journal of Healthcare and Medical Research, Vol - 12(1). 83-92.
Hernández, J. L. G., Cabello, J. de J. U., Barrón, G. M., Suárez, I. A. L., Segura, C. A. S., Medina, M. S. H., & Sánchez, M. A. G. (2025). Medical Colostomy: A New Resource. British Journal of Healthcare and Medical Research, Vol - 12(04). 43-58.
Farmoderm. Laboratorio farmacológico Milano. Consultado el día 13 de noviembre de 2025. Extraído de https://farmoderm.it/es/10-maneras-de-identificar-irritacion-en-la-piel-periestomal-y-como-manejarla/
Salrin J, Stewart DB. Management of Severe Clostridioides difficile Infection. Infect Dis Clin North Am. 2025 Dec;39(4):653-662. doi: 10.1016/j.idc.2025.07.006.
Killeen S, Gunn J, Hartley J. Surgical management of complicated and medically refractory inflammatory bowel disease during pregnancy. Colorectal Dis. 2017 Feb;19(2):123-138. doi: 10.1111/codi.13413.
Aytac E, Ozuner G, Isik O, Gorgun E, Remzi FH. Surgical management of patients with ulcerative colitis during pregnancy: maternal and fetal outcomes. J Crohns Colitis. 2015 Jan;9(1):82-5. doi: 10.1093/ecco-jcc/jju001.
Sánchez, M. A. G., González, M. F., Cortés, I. Y. P., Rodríguez, M. I. E., Estrella, M. L. T., Godínez, J. I. J., Longines, F. C., García, G. C., Jiménez, A. A., Vargas, A. O., García, B. R. L., Barrón, G. M., Hernández, J. G. F., Carrillo, C. A. Z., & Zenteno, S. F. (2023). Ulcerous Colitis in Mexico: Is It Still a Diagnostic-Therapeutic Myth? 20 Years of Experience. British Journal of Healthcare and Medical Research, Vol - 10(4). 145-163.
Uribe AA, Weaver TE, Echeverria-Villalobos M, Periel L, Shi H, Fiorda-Diaz J, Gonzalez-Zacarias A, Abdel-Rasoul M, Li L. Perioperative Morbidity and Complications in Patients With an Established Ileostomy Undergoing Major Abdominal Surgery: A Retrospective Study. Front Surg. 2021 Dec 8;8:757269. doi: 10.3389/fsurg.2021.757269.
Zhao S, Ma X, Wang Y, Bai Y, Yan C. Evidence-based leakage management in cancer-preventive ileostomy care: A Delphi consensus integrating systematic review and clinical expertise. Asia Pac J Oncol Nurs. 2025 Apr 21;12:100703. doi: 10.1016/j.apjon.2025.100703.
Elsawwah JK, Gopinath SA, Stopper PB, Rolandelli RH, Nemeth ZH. Renal Insufficiency After Colectomy With or Without Ileostomy. Am Surg. 2025 Dec;91(12):2104-2110. doi: 10.1177/00031348251346525.
De Carlo G, Belkovsky M, Lavryk OL, Kanters A, Falloon K, Naseer M, Braga-Neto M, Qazi T, Cohen B, Lipman J, Liska D, Hull T, Holubar S. Pouch advancement flaps for the surgical management of complex pouch-related fistulas: Is there a difference between pouch perineal and pouch vaginal fistulae? Surgery. 2025 Nov; 187:109638. doi: 10.1016/j.surg.2025.109638.
Santos FDCGG, Barbosa LER, de Araújo Teixeira JPM (2024) Ileostomy: early and late complications. J Coloproctology 44(1): E80–E86.
Fujii Y, Asai H, Uehara S, Kato A, Watanabe K, Suzuki T, Ushigome H, Takahashi H, Matsuo Y, Takiguchi S. A novel technique for the construction of an end ileostomy to prevent stoma outlet obstruction after rectal resection and total colectomy: a single-center retrospective study. Surg Today. 2025 May;55(5):705-715. doi: 10.1007/s00595-024-02956-1.
Toffaha A, Badr A, Al-Dhaheri M, Aleter A, Latif E, Kurer M, Ahmed A, Naimi NA, Abu-Issa I, Fatima T, Parvaiz A, Nada MA. Risk factors for stoma outlet obstruction: systematic review and meta-analysis. Langenbecks Arch Surg. 2025 Oct 29;410(1):317. doi: 10.1007/s00423-025-03892-5.
Tang J, Wang L, Ji D, Du J, Jin K, Wang Y, Wang X, Sun Y. Association of Mesenteric Molding Suturing on Parastomal Hernia Incidence: Retrospective Study. J Surg Res. 2025 Nov 10;315:973-981. doi: 10.1016/j.jss.2025.10.017.
Akita S, Ishimaru K, Sato M, Watanabe K, Sugishita H, Ogi Y, Kuwabara J, Tanigawa K, Kikuchi S, Matsumoto H, Yoshida M, Koga S, Oshikiri T. Early Laparoscopic Colostomy in Advanced Cancer Patients with Rectovaginal Fistula: Results of Seven Patients. J Nippon Med Sch. 2025 Nov 6;92(5):414-419. doi: 10.1272/jnms.JNMS.2025_92-504.
Fu Y, Cheng Y, Zhang C, Wang J, Li R, Zhao S, Zhou J, Wang Y, Wang W, Wang L, Ren J, Wang D. Development and validation of a prognostic model for the occurrence of parastomal hernia in patients undergoing permanent colostomy based on various computed tomography indices. Surg Endosc. 2025 Nov 3. doi: 10.1007/s00464-025-12251-w.
Shang A, Li L, He G, Zhuge D, Yu P, Xu J. Risk factors for parastomal hernia following abdominoperineal resection. Front Oncol. 2025 Oct 29;15:1692769. doi: 10.3389/fonc.2025.1692769.
Hasnaoui, A., Trigui, R., Heni, S. et al. Evisceración paraestomal posoperatoria temprana tras laparotomía exploratoria: reporte de un caso de una complicación quirúrgica rara y potencialmente mortal. Patient Saf Surg 17, 26 (2023). https://doi.org/10.1186/s13037-023-00379-4.
Sasaki T, Nishinari Y, Hiraka M, Mori A, Oyama K, Sasaki A. [A Case of Peristomal Abscess after Treatment with Panitumumab]. Gan To Kagaku Ryoho. 2025 Nov;52(11):829-831. Japanese. PMID: 41253350.
Burgess-Stocks J, Gleba J, Lawrence K, Mueller S. Ostomy and Continent Diversion Patient Bill of Rights: Research Validation of Standards of Care. J Wound Ostomy Continence Nurs. 2022 May-Jun 01;49(3):251-260. doi: 10.1097/WON.0000000000000876. Erratum in: J Wound Ostomy Continence Nurs. 2022 Sep-Oct 01;49(5):399. doi: 10.1097/WON.0000000000000916. 128
Antequera-Antequera Á, Valenza-Peña G, Raya-Benítez J, Navas-Otero A, Valenza MC, Calvache-Mateo A, Cabrera-Martos I. Home-Based, Telematic Gradual Exercise for Permanent Colostomy Patients: Protocol for a Randomized Controlled Trial. Healthcare (Basel). 2025 Oct 29;13(21):2742. doi: 10.3390/healthcare13212742.
Prieto L, Thorsen H, Juul K. Development and validation of a quality-of-life questionnaire for patients with colostomy or ileostomy. Health Qual Life Outcomes. 2005 Oct 12;3:62. doi: 10.1186/1477-7525-3-62.
Matos Casano HA, Ahmed I, Anjum F. Six-Minute Walk Test. 2025 Jul 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 35015445.
Ritter PL, Lorig K. The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies. J Clin Epidemiol. 2014 Nov;67(11):1265-73. doi: 10.1016/j.jclinepi.2014.06.009. Epub 2014 Aug 3. PMID: 25091546.
Bharucha AE, Knowles CH, Malcolm A. An Evidence-Based Practical Review on Common Benign Anorectal Disorders: Hemorrhoids, Anal Fissure, Dyssynergic Defecation, and Fecal Incontinence. Gastroenterology. 2025 Nov 14:S0016-5085(25)05798-1. doi: 10.1053/j.gastro.2025.07.031. Epub ahead of print. PMID: 41236452.
Karam B, Shui AM, Pandey S, Zhao B. Patterns of Sacral Nerve Modulation Adoption: Impact of State Licensure, Region, and Urbanicity. J Surg Res. 2025 Nov 8;315:959-965. doi: 10.1016/j.jss.2025.10.003. Epub ahead of print. PMID: 41207132.
Younis J, Salerno G, Fanto D, Hadjipavlou M, Chellar D, Trickett JP. Focused preoperative patient stoma education, prior to ileostomy formation after anterior resection, contributes to a reduction in delayed discharge within the enhanced recovery programme. Int J Colorectal Dis. 2012 Jan;27(1):43-7. doi: 10.1007/s00384-011-1252-2.
Chaimee M, Attawet J, Qiu Y, Hugh TJ, Murray-Parahi P, Wilson A. Improving delayed discharge in gastrointestinal surgery patients: An integrative review. Int J Nurs Stud Adv. 2025 Sep 8;9:100417. doi: 10.1016/j.ijnsa.2025.100417.
Doughty DB, Beitz JM, Colwell J, McNichol L, Gray M. Measurement of Flexibility and Compressibility in Convex Ostomy Barriers: Report of a Transdisciplinary Consensus Conference. J Wound Ostomy Continence Nurs. 2025 Nov-Dec 01;52(6):469-475. doi: 10.1097/WON.0000000000001223. Epub 2025 Nov 11. PMID: 40993941.
Zhang X, Liu J, Wang X, Wang Z. Core Supportive Care Needs of Ostomy Patients at Different Postoperative Times: A Network Analysis. J Clin Nurs. 2025 Nov;34(11):4810-4818. doi: 10.1111/jocn.17751. Epub 2025 Mar 25. PMID: 40130677.
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Copyright (c) 2025 José Luis García Hernández, José de Jesús Urbina Cabello, Ivonne Alondra León Suárez, Juan Antonio Juarez Avila, Lya Yadira Celada Frausto, Aldebharán Avila Ríos, Rafael Martínez Sanciprián, García Sánchez Morelos Adolfo
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