Bowel Management Table 15a: Systematic Review on Colostomy

Authors; Country

Date included in the review

Total Sample Size

Types of Articles




Level of Evidence


Hocevar and Gray 2008;



Reviewed published articles from January 1960 to November 2007


N= 6 

n=203 SCI


Types of Articles:

2 case-control

3 interviews

1 cross-sectional survey



Methods: literature search forprospective and retrospective studies that directly compared clinical, functional, quality of life outcomes or satisfaction among patients with intestinal diversions to patients managed by conservative means.


Databases: MEDLINE, CINAHL, Cochrane Database for Systematic Reviews, Google Scholar


Level of Evidence: No formal validity assessment was described


  1. Creation of an ostomy in selected patients provides equivocal or superior quality of life outcomes when compared to conservative bowel management
  2. Both colostomy and ileostomy surgery significantly reduce the amount of time required for bowel management (Level of Evidence: 3).
  3. Patients who undergo ostomy surgery tend to be satisfied with their surgery, and a significant portion report a desire to be counselled about this option earlier.
  4. There are no clear advantages when functional, clinical, or quality of life outcomes associated with colostomy are compared to those seen in SCI patients undergoing ileostomy (Level of evidence: 4).