title: The Difficult Stoma: Challenges and Strategies.
abstract: The problems that a patient experiences after the creation of a temporary or permanent stoma can result from many factors, but a carefully constructed stoma located in an ideal location is typically associated with appropriate function and an acceptable quality of life. The construction of the stoma can be confounded by many concomitant conditions that increase the distance that the bowel must traverse or shorten the bowel's capacity to reach. Stomas can be further troubled by a variety of problems that potentially arise early in the recovery period or months later. Surgeons must be familiar with these obstacles and complications to avoid their occurrence and minimize their impact.
authors.affiliation: Gastrointestinal and Oncologic Surgery, Digestive Health Center, Northwestern Medicine, Chicago, Illinois.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Strong
keywords: ostomy; peristomal hernia; prolapse; retraction; technique