Reoperative surgery for gastrointestinal stomal problems

The creation and management of ostomies are integral components of the general and colorectal surgeon's surgical arsenal in the treatment of gastrointestinal (GI) disorders. Ostomies often result in significant psychological trauma for the patient; thus proper education, formation, management, and closure are critical in ensuring patient satisfaction and maintaining quality of life. Approximately 750,000 Americans currently live with an ostomy, and more than 75,000 new stomas are performed each year. Although in years past, ostomies were performed for the permanent management of GI tract output, the majority of contemporary stomas are created as a temporary measure, either as an end ostomy in the acute setting, or as proximal diversion for protection of a risky anastomosis with plans for future restoration of intestinal continuity. This chapter addresses complications associated with GI stomas and operative procedures to treat these complications.