coloproctology

, Volume 40, Issue 2, pp 145–160 | Cite as

Stoma

CME
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Zusammenfassung

Die Anlage eines Enterostomas erfolgt im Rahmen von abdominalchirurgischen Elektiv- und Notfalleingriffen, z. B. bei Tumorerkrankungen und Divertikulitis. Dabei wird ein Darmanteil durch die Bauchwand ausgeleitet und je nach verwendetem Darmabschnitt (Jejuno‑, Ileo- oder Kolostomie), Funktion (definitiv oder temporär) und Technik (doppelläufig oder endständig angelegtes Stoma) weiter beschrieben. Neben der temporären Protektion der Heilung nachgeschalteter Anastomosen ist die Stomaanlage bei Entfernung bzw. Aufgabe des Schließmuskels aus onkologischen oder funktionellen Gründen häufig alternativlos. Mehr als die Hälfte aller Stomaträger entwickelt Probleme bei der Versorgung, u. a. wegen Hautirritationen und Entleerungsstörungen. Eine standardisierte Vorbereitung und operative Anlage eines prominenten Stomas sowie eine prä- und postoperative Begleitung der Patienten durch Stomatherapeuten und Ärzte sind Voraussetzung für eine selbstbestimmte Versorgung und Lebensqualität.

Schlüsselwörter

Ileostomie Kolostomie Jejunostomie Stomakomplikationen Lebensqualität 

Ostomy

Abstract

Ostomies are created in the management of a variety of medical conditions, including cancer and diverticulitis. A portion of the intestine is pulled through the abdominal wall and further described by anatomy (ileostomy, colostomy), function (permanent, protective ostomy), and technique (loop, end ostomy). Besides temporary protection of anastomotic healing, the creation of a stoma is almost the only option for patients with loss of anal sphincter due to oncological or functional reasons. More than half of the ostomies are problematic, presenting management problems including skin irritation and pouching difficulties. Thus, a standardized site marking and creation of an ostomy that should be fashioned to protrude above the skin surface and pre- and postoperative support provided by stoma therapists and physicians are crucial for ostomy self-management and quality of life of affected patients.

Keywords

Ileostomy Colostomy Jejunostomy Complications, ostomy Quality of life 

Notes

Danksagung

Der Autor dankt Herrn Günter Gerig, Stomatherapeut am Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, für die Anfertigung der Fotografien.

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Gröne gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Allgemein- und ViszeralchirurgieRotes Kreuz KrankenhausBremenDeutschland

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