Overview

Many patients with rectal cancer require a temporary or permanent ostomy. Operations that include an ostomy have high complication rates compared with operations without an ostomy. National Surgical Quality Improvement Program data showed a 37% complication rate for elective cases that include an ostomy.[1] Ostomy-specific complications, including difficulties with pouching, appliance leakage, and local complications, are even more common and may profoundly affect quality of life (Figure 1).[2] Ostomy complication rates vary by hospital, suggesting the potential for improvement in the technical aspects of ostomy creation, as well as the quality of perioperative care.[2] Pyoderma gangrenosum is rare and most commonly associated with patients who have inflammatory bowel disease. Likewise, equally rare is peristomal varices, which are associated with patients who have portal hypertension.[3] This section will concentrate on the more common complications that can occur after stoma formation along with recommended prevention and treatment strategies.

Figure 1. Patient With Dermatitis due to Leaking Stomal Contents