Lightner AL, Pemberton JH, et al.
Clinics in colon and rectal surgery. Date of publication 2017 Jul 1;volume 30(3):178-183.
1. Clin Colon Rectal Surg. 2017 Jul;30(3):178-183. doi: 10.1055/s-0037-1598158. Epub
2017 May 22.
The Role of Temporary Fecal Diversion.
Lightner AL(1), Pemberton JH(1).
Author information:
(1)Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic
College of Medicine, Rochester, Minnesota.
The use of temporary fecal diversion is of great importance to tenuous
anastomosis, immunosuppressed patient, or actively infected patient. Its use
protects newly constructed intestinal anastomoses from being the culprit of
pelvic sepsis or systemic illness. Thus, potential morbidity and mortality can be
averted. However, its appropriate or optimal use is often debated. We herein
discuss the evidence for when to best use a diverting stoma for colorectal,
coloanal, and ileoanal anastomoses. We also discuss the importance of considering
a temporary diverting stoma in the setting of high-dose immunosuppression (e.g.,
transplant patients or inflammatory bowel disease), active infection, or upon
creation of ileal pouch-anal anastomosis. Lastly, we discuss the advantages and
disadvantages of a loop ileostomy versus colostomy for temporary diversion of
fecal contents.
DOI: 10.1055/s-0037-1598158
PMCID: PMC5498160
PMID: 28684935
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