Today, surgeons almost always create a stoma through a left or right rectus muscle-splitting incision to avoid placement at the midline laparotomy wound of patients. In the past, some surgeons preferred to create a colostomy in the umbilicus, but the practice did not gain general acceptance and the umbilicus had been regarded as a site to avoid for stoma creation. However, this attitude has recently changed in the field of pediatric surgery and adult laparoscopic surgery. The umbilical site has been used for temporary colostomies for neonates or infants with anorectal malformation or Hirschsprung’s disease. Further, umbilical diverting loop ileostomies have been developed to prevent leakage in adult patients undergoing laparoscopic colorectal surgery, whose umbilicus had already been open at the time of the bowel extraction. These reports indicate the umbilical stoma is feasible, safe and cosmetically superior when reversed.
Here we review the history of stoma creation and recent utilization of the umbilical stoma and provide a brief discussion on future perspectives.
Ishiguro S*, Komatsu S, Komaya K, Saito T, Arikawa T, Kaneko K, Miyachi M and Sano T
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