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Colorectal Cancer Surgery

Other Procedures for Colorectal Cancer

  • Stomas or ostomies. A stoma is an opening of some part of the bowel onto the skin. A colostomy is an opening of the colon onto the skin and an ileostomy is an opening of the ileum (or small intestine) onto the skin. A colostomy or an ileostomy may be permanent or temporary. Permanent stomas are made when stool cannot go through its normal route after surgery. Temporary stomas are made to keep stool away from a damaged or recently operated area while healing occurs. The stool that comes out of a stoma is collected in a bag.
  • Fecal diversion. This procedure is used to create an ileostomy (opening between the surface of the skin and the small intestine) or colostomy (opening between the surface of the skin and the colon). This is often used as a temporary measure to allow for healing of an infection, recent surgery, or chronic inflammation.
  • K pouch. The K pouch is also known as the "continent ileostomy." Unlike the J pouch (see below), which is attached to the anus to allow you to go to the bathroom the usual way, the K pouch is a fancy form of an ileostomy. Unlike a usual ileostomy which needs to be attached to a bag outside the body, the K pouch provides a reservoir for the stool and adds a nipple valve to prevent the stool from leaking. The pouch is emptied by inserting a stiff catheter through the stoma, which is covered with gauze in between emptying. One problem with the pouch, and the reason it is not very popular among surgeons, is that the valve often comes undone, or slips, and another operation is needed to repair it. The surgery is very complex and long-term problems are common. This is usually only used if the ileal pouch (see below) is not an option.
  • Ileal (J) pouch. To replace the rectum and provide a place to store the stool before going to the bathroom after a total proctocolectomy (see above), surgeons can sometimes create a pouch out of the end of the small intestine called the ileum. There are different forms of the ileal pouch, named after the shape in which the end of the small intestine is placed before it is sewn (or stapled) to make a pouch. The most common form is the "J" pouch. Creating the pouch is complicated and it sometimes doesn't work. To improve your chances, the surgeon will make a temporary ileostomy to allow the pouch to heal without having to defend itself from a stream of stool. Usually, the temporary ileostomy can be reversed after about two to three months.


WebMD Medical Reference

Reviewed by Sujana Movva, MD on January 26, 2015
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