Contents


Preface

Gastrointestinal stoma is a therapeutic measure that has been evident for a long time but which retains its validity even among the great and overwhelming advances in clinical practice. Some technical details of the performance of stomas and the frequency of use of the procedure have dramatically reduced but the indications have not changed. Currently, the vast majority of gastrointestinal stomas are temporary. Surgical indications of gastrointestinal stomas in different sites of the digestive tract are based on various pathological conditions. Frequency of the employment of intestinal stomas has varied greatly as time passes, and is linked to evolutions of therapeutic perspectives. Furthermore, the surgical techniques had ameliorative modifications with changes in therapeutic procedures. Most intestinal stomas are temporary, with a program to restore intestinal continuity: emergency ostomy in particular cases of intestinal obstruction, some anastomoses such as coloanal or ileoanal needing temporary diverting ileostomy, and temporary feeding ileostomy. Great care is required in performing and treating ostomy, because the procedure is a fundamental part of the therapeutic program and involves the surgeon, the patient, and the nurse stoma therapist. The therapeutic commitment of ostomy is not limited to local control but involves the evaluation and treatment of general conditions in ostomy feeding and the balance of fluid and electrolyte depletion in cecostomy and diverting

The first section, "Stoma Care," consists of four chapters. The "Introductory Chapter: Role of Colostomy in the Colorectal Pathologies" shows synthetically the current use of colostomy as a complement to colorectal surgery, with the changes that have occurred. The chapter "Stoma Revision on the Flaps in Cases of Abdominal Wall Defect with Digestive Tract Rupture" exposes the very complex topic of incisional hernia with abdominal wall defect, involving intestinal stoma. Resolution of this technical problem comprises various and discussed surgical procedures. The chapter "Intestinal Ostomy Complications and Care" develops completely and clearly the planning of ostomy and the outcomes of intestinal stomas evaluating functional and anatomopathological complications. The chapter "Gastric Microbiota: Between Health and Disease" is very interesting. The chapter introduces the important theme of the change in intestinal microbiota following gastrointestinal stomas. This topic in particular looks at cases of stomas that need

In the second section, "Stomas Prevention," there are two chapters. The chapter "Full Colonoscopy in Patients under 50 Years Old with Lower Gastrointestinal Bleeding" shows a clinical problem of great social impact: early diagnosis of colonic neoplasm from non-specific signs of gastrointestinal bleeding. This topic looks at the role of full colonoscopy compared with sigmoidoscopy and the usefulness of early diagnosis to prevent the risk of ostomy in the therapeutic program of colorectal cancer. The chapter "Radioimaging Diagnosis of Vaterian Ampulloma: Technique, Semiology, and Differential Diagnosis - Review" shows the complex diagnostic problem of perivaterian pathologies. Correct diagnosis allows the

ileostomy.

enteral feeding.
