Surgical strategy for stoma creation in the challenging patients.
10.3760/cma.j.cn441530-20220711-00299
- VernacularTitle:困难造口患者的手术策略
- Author:
Ye WANG
1
;
Zheng LOU
1
;
Wei ZHANG
1
Author Information
1. Department of Colorectal Surgery, the First Affiliated Hospital of Navy Medical University, Shanghai 200433, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Surgical Stomas;
Incisional Hernia;
Enterostomy;
Intestinal Obstruction;
Obesity
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(11):961-964
- CountryChina
- Language:Chinese
-
Abstract:
Stoma is a commonly used surgical procedure in clinic practice. However, for obese patients with thick abdominal wall, short and thickened mesentery, and for patients with intestinal obstruction and abdominal distension (difficult stoma), establishing a tension- free and well blood-supplied stoma is still a great challenge. Careful preoperative planning, including stoma location marking, careful consideration of all alternatives and attention to technical details, will help to make an optimal stoma under challenging conditions. For enterostomy of obese patients, the pullout intestine must be free of tension and must have sufficient blood supply, the structure of the abdominal wall should be incised vertically, and the intestine should be pulled out vertically as well. For enterostomy of patients with intestinal obstruction, the diameter of the stoma incision should not exceed 3 cm to avoid parastomal hernia, which commonly occurs after bowel retraction.
