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2018 ; 115
(11
): 182-187
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Intestinal Ostomy
#MMPMID29607805
Ambe PC
; Kurz NR
; Nitschke C
; Odeh SF
; Möslein G
; Zirngibl H
Dtsch Arztebl Int
2018[Mar]; 115
(11
): 182-187
PMID29607805
show ga
BACKGROUND: About 100 000 ostomy carriers are estimated to live in Germany today.
The creation of an ostomy represents a major life event that can be associated
with impaired quality of life. Optimal ostomy creation and proper ostomy care are
crucially important determinants of the success of treatment and of the patients'
quality of life. METHODS: This article is based on pertinent publications
retrieved by a selective search in PubMed, GoogleScholar, and Scopus, and on the
authors' experience. RESULTS: Intestinal stomata can be created using either the
small or the large bowel. More than 75% of all stomata are placed as part of the
treatment of colorectal cancer. The incidence of stoma-related complications is
reported to be 10-70%. Skin irritation, erosion, and ulceration are the most
common early complications, with a combined incidence of 25-34%, while stoma
prolapse is the most common late complication, with an incidence of 8-75%. Most
early complications can be managed conservatively, while most late complications
require surgical revision. In 19% of cases, an ostomy that was initially planned
to be temporary becomes permanent. Inappropriate stoma location and inadequate
ostomy care are the most common causes of early complications. Both surgical and
patient-related factors influence late complications. CONCLUSION: Every step from
the planning of a stoma to its postoperative care should be discussed with the
patient in detail. Preoperative marking is essential for an optimal stoma site.
Optimal patient management with the involvement of an ostomy nurse increases
ostomy acceptance, reduces ostomy-related complications, and improves the quality
of life of ostomy carriers.