[Gastrointestinal surgery and gastroenterology. XI. Stomas and stoma surgery].
Stomas are an essential part of gastrointestinal surgery. Indications for stoma construction are faecal diversion from a distal diseased bowel segment, prevention of an intestinal anastomosis in intra-abdominal sepsis, and faecal incontinence. Pre- and postoperative counselling and nursing care is essential for a good functional outcome. Following stoma construction, complications such as dermatitis, retraction, prolapse, stenosis and parastomal hernia occur in 30-60% of cases. Thirty percent of stomas need surgical re-intervention in the first 10 years. For diversion of a distal anastomosis, construction of a loop-ileostomy is preferred to a loop-colostomy. Closure of a temporary stoma should not be done within eight weeks of construction. Preoperative evaluation of the distal segment is mandatory. Stoma closure involves an intra-abdominal anastomosis with all its associated complications. The incidence of complications after stoma closure is about 10%.
Kuijpers
J H
JH
Bernhoven Ziekenhuis, locatie Veghel, afd. Chirurgie, Postbus 10,000, 5460 DA Veghel.
D003106:Colon / Q000601:surgery*; D004766:Enterostomy / Q000009:adverse effects / Q000379:methods*; D005762:Gastroenterology / Q000379:methods / Q000639:trends*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D009426:Netherlands; D054047:Surgical Stomas / Q000009:adverse effects / Q000706:statistics & numerical data*