History of surgery: The evolution of views on the formation of intestinal stoma

Abstract

The history of intestinal stoma surgery spans more than one century. Awareness of the possible benefits of creating an intestinal stoma came to the medical community long before the practical possibilities of its safe formation. At the same time, the evolution of the attitude towards the intestinal stoma has passed the stages of understanding the possibility of creating an artificial anus, understanding the need and expediency of such an intervention through the search for optimal techniques and the type of the stoma itself. Its connotation as the final stage of treatment of various coloproctological diseases has been formed amid the emergence of modern asepsis and antiseptics. And as a result of improving the operational technique of the main stage of the operation, the colo-(ileo-)stoma became only a temporary companion of a significant part of patients. The improvement of care methods has led to a significant improvement in the quality of life, even in life-long stoma patients. The analysis of the content of works on the description of the use of intestinal stomas in surgery of the abdomen allows us to formulate ideas about the evolution of views on the role and importance of an unnatural anus, in the treatment of diseases and injuries of the intestine. Until the 18th century, professional physicians accumulated isolated personal experience and came to the realization of the possibility of excretion of feces bypassing the rectum. In the 18th century, the fatalism of passive observation of the patient is replaced by active tactics of struggle for their life. In the 19th century, surgeons in Europe are searching for the optimal localization of intestinal stoma and expand the indications for its formation. Since the beginning of the 20th century, there is a variety of kinds of stomas, expanding the range of indications for it. In the second half of the 20th century, the passion for technical aspects of stoma-surgery is replaced by stoma-therapy to improve the quality of life patients with a permanent stoma.