**2. Functional and anatomical characteristics of colostomy**

The first subdivision is between temporary and definitive colostomy; this distinction is based on the therapeutic perspective. Following anatomical criterion, the stomas can be divided as terminal and parietal. The parietal colostomies encompass cecostomy and loop colostomy. They are usually temporary, and fecal diversion is often partial; their site can be right iliac fossa (cecostomy) or left iliac fossa (sigmoidostomy) and right paraumbilical site (transverse colonoscopy). Loop colostomy can be stabilized by a stick. Cecostomy usually is completed by the self-retained catheter fixed by the purse-string suture. Technical simplicity and rapid accomplishment are the characteristics of cecostomy. In the past, the parietal colostomies, as transverse colostomy, have been employed with the aim to prevent the leakage or dehiscence of the colorectal anastomosis, but now this role has been denied. In summary cecostomy may be indicated as a means of gas decompression in colonic obstruction, and transverse colostomy can instead ensure fecal diversion which is generally partial. End colostomy allows total fecal diversion. This can be employed in case of resection of diseased segment of the colon, and the immediate, contextual anastomosis is judged to be uncertain and not indicated. End colostomy is recommended rather than loop colostomy as permanent ostomy. In some conditions, such as Hartmann's procedure, there is also the distal end of the colon that can be treated as mucus fistula.
