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The first edition was published as Intestinal Stomas: Principles, Techniques, and Manage-
ment, edited by John M. MacKeigan and Peter A. Cataldo, published by Quality Medical
Publishing, Inc., St. Louis, Missouri (1993).
Although great care has been taken to provide accurate and current information, neither the
author(s) nor the publisher, nor anyone else associated with this publication, shall be liable
for any loss, damage, or liability directly or indirectly caused or alleged to be caused by
this book. The material contained herein is not intended to provide specific advice or recom-
mendations for any specific situation.
Trademark notice: Product or corporate names may be trademarks or registered trademarks
and are used only for identification and explanation without intent to infringe.
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress.
ISBN: 0-8247-4707-0
This book is printed on acid-free paper.
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information, write to Special Sales/Professional Marketing at the headquarters address
above.
Copyright 2004 by Marcel Dekker, Inc. All Rights Reserved.
Neither this book nor any part may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, microfilming, and recording, or
by any information storage and retrieval system, without permission in writing from the
publisher.
Current printing (last digit):
10987654321
PRINTED IN THE UNITED STATES OF AMERICA
To my wife, Eileen, and to my daughters, Colleen and Anna, my advisors
and my best friends. —PAC
With appreciation to Suzie, my family, and my teachers. —JMM
Preface
Ten years have passed since the publication of the first edition of Intestinal
Stomas: Principles, Techniques, and Management. That text was envi-
sioned and created in response to a need for a comprehensive reference on
intestinal stomas. Prior to our first edition, The Atlas of Intestinal Stomas,
authored by Drs. Rupert Turnbull and Frank Weakley nearly 30 years ago,
was the only textbook dedicated to intestinal stomas and remained the au-
thoritative source. Thanks to the contributions of many intelligent and dedi-
cated surgeons, our first edition was recognized as the up-to-date source
for ostomy creation and care. Only by standing on the shoulders of the
“fathers of the field” of intestinal stomas and enterostomal therapy were we
able to create that book, and we now stand also on its shoulders to bring to
our readers a second edition.
This edition contains two entirely new chapters, “Pediatric Intestinal
Stomas” and “Technical Tips for the Difficult Stoma.” The first is a superb
compilation of stomas in children used in the treatment of Hirschsprung’s
disease, imperforate anus, necrotizing enterocolitis, and constipation. The
second new chapter, Technical Tips for the Difficult Stoma, covers solu-
tions to age-old problems of emergency stoma creation, particularly in
obese patients with inflammatory conditions leading to thickened and short-
ened intestinal mesentery.
In addition, all remaining chapters have been revised, often by a new
author in order to ensure a fresh approach. New, current references have
been added to all chapters. A new section on endoscopically assisted tre-
phine stomas has been added to the chapter “Minimally Invasive Stomas.”
New approaches to the treatment of stomal prolapse, parastomal hernias,
and peristomal pyoderma gangrenosum have also been included.
Much has changed since the completion of our first edition. We have
made every effort to ensure that the second edition addresses all these
v
vi Preface
changes and will be considered the authoritative source on intestinal
stomas.
Thank you to our dedicated contributors, without whose help this text
would not exist, and to our publisher Marcel Dekker, Inc., who coordinated
and facilitated our efforts. Special thanks to Tina Blais-Armell, without
whose dogged determination and persistence this textbook would still be a
pile of papers on the office floor. Thank you to our enterostomal therapists,
Cindy Whitehead, Randy VanAlst, and Kristin Hurt, who continue to teach
us invaluable lessons about living with ostomies, and to our students, who
teach us more than we will ever be able to teach them. Finally, we would
like to extend our deepest gratitude to our patients, who have inspired us,
learned with us, and taught us lessons that can be learned only by living
with an intestinal stoma.
Peter A. Cataldo
John M. MacKeigan
Contents
Preface iii
Contributors vii
1. History of Stomas 1
Peter A. Cataldo
2. Stoma Physiology 39
William E. Taylor and John H. Pemberton
3. Preoperative Considerations 57
Alan G. Thorson
4. Stoma Therapy 65
Ian C. Lavery and Paul Erwin-Toth
5. Quality of Life with a Stoma 91
Robin S. McLeod and Zane Cohen
6. End Sigmoid/Descending Colostomy 111
Thomas E. Cataldo
7. Diverting Stomas 121
Russell K. Pearl, Amir L. Bastawrous, and Herand Abcarian
8. Cecostomy 143
Anthony J. Senagore
9. End Ileostomy 151
Neil Hyman
vii
viii Contents
10. Continent Stomas 165
Stephen R. Gorfine
11. Ostomy Take-Down 203
Scott A. Strong
12. Methods of Urinary Diversion 215
Jeffrey A. Stern and Daniel P. Dalton
13. Laparoscopic-Assisted Colostomy 259
Martin A. Luchtefeld
14. Ileostomy and Pouch Dysfunction 267
Peter W. Marcello and Amanda M. Metcalf
15. Parastomal Hernias 277
Marc S. Rubin
16. Stomal Prolapse 307
Seth Rosen and Juan J. Nogueras
17. Management of Intestinal Fistulas 323
W. Douglas Wong, W. Donald Buie,
and Ravinder K. Annamaneni
18. Nursing Management of Cutaneous Intestinal Fistulas 355
Bonnie Sue Rolstad and W. Douglas Wong
19. Diagnosis and Treatment of Peristomal Skin Conditions 381
Najjia N. Mahmoud and Brenda S. Bradley
20. Unusual Problems in Stoma Management 397
Kerry M. Casey, Donna L. Loehner, and David J. Schoetz, Jr.
21. Technical Tips for the Difficult Stoma 411
Peter A. Cataldo
22. Pediatric Intestinal Stomas 427
Michael V. Tirabassi, David B. Tashjian, Gregory Banever,
and Stanley Konefal
Appendix A United Ostomy Association, Inc. 467
Appendix B CCFA Across the Nation 493
Index 499
Contributors
Herand Abcarian University of Illinois at Chicago, Chicago, Illinois
Ravinder K. Annamaneni Memorial Sloan-Kettering Cancer Center,
New York, New York, U.S.A.
Gregory Banever Department of Surgery, Baystate Medical Center, Spring-
field, Massachusetts, U.S.A.
Amir L. Bastawrous Cook County Hospital, Chicago, Illinois, U.S.A.
Brenda S. Bradley Thomas Jefferson University Hospital, Philadelphia,
Pennsylvania, U.S.A.
W. Donald Buie Calgary, Alberta, Canada
Kerry M. Casey Lahey Clinic, Burlington, Massachusetts, U.S.A.
Peter A. Cataldo University of Vermont College of Medicine, Burling-
ton, Vermont, U.S.A.
Thomas E. Cataldo University of Medicine and Dentistry of New Jersey,
Robert Wood Johnson Medical School, Cooper Health System, and Cooper
Colorectal Care Center, Camden, New Jersey, U.S.A.
Zane Cohen Mount Sinai Hospital, Toronto, Ontario, Canada
Daniel P. Dalton Northwestern University Medical School, Chicago, Illi-
nois, U.S.A.
Paul Erwin-Toth The Cleveland Clinic Foundation, Cleveland, Ohio,
U.S.A.
ix