Intestinal ostomies
Colon Polyps and Colorectal Cancer: Second Edition, Springer International Publishing Ag, ss.379-407, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Doi Numarası: 10.1007/978-3-030-57273-0_19
- Yayınevi: Springer International Publishing Ag
- Sayfa Sayıları: ss.379-407
- Anahtar Kelimeler: Colostomy, Complications, Ileostomy, Indications, Management, Minimally invasive, Ostomy, Ostomy construction, Stoma, Stomy closure
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
A stoma is an intentional anastomosis between a part of the gastrointestinal system and cutaneous tissue of anterior abdominal wall. Indications may include miscellaneous causes such as relieving a distal obstruction and diversion of fecal flow away from a distal anastomosis. Preoperative stoma siting promotes self-care, reduces stoma-related complications, and improves postoperative quality of life. A stoma can be end-on or loop. Modern stoma construction is more frequently done by minimally invasive techniques. For ulcerative colitis patients with a desire to preserve physiologic defecatory function who are not candidates for ileal pouch-anal anastomosis, continence ileostomy can be an option. In enterostomies with high output, loss of enteral contents can lead to dehydration, electrolyte abnormalities, vitamin deficiencies, and malnutrition. Patients with high output ostomies are managed with oral and intravenous fluid and electrolyte replacement, vitamin replacement, restriction of hypotonic fluids, anti-peristaltic and anti-secretory medications. Incidence of stomal complications is between 14% and 79%. They may occur in the early postoperative period or years after the construction of stoma. The most common complication is peristomal skin irritation. Parastomal hernia, stomal stenosis, retraction, bleeding, and prolapse are among the other complications that can be encountered commonly.