The last quarter century has seen the gradual development of ileostomy from an unmitigated disaster to a stoma brought to a level of efficiency that has made it acceptable not only as a gastrointestinal but also as a urinary conduit, thanks to the invention by Rutzen of the adherent bag and its subsequent development. The first step was to produce a stoma around which the bag could be comfortably placed and worn. This presented no technical difficulties and led to the effective application of surgery to the field of ulcerative colitis; increasing familiarity permitted the ablative surgery for this disease to move from staged procedures to removal of the large intestine at one operation. However, a serious problem of immediate postoperative diarrhea arose, with patients losing as much as 3 liters of fluid via the stoma per day, complicating biochemical disturbances due to loss of fluid and electrolytes in those
BROOKE B. Ileostomy Diarrhea. Arch Surg. 1975;110(7):781–782. doi:10.1001/archsurg.1975.01360130013002
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