Zusammenfassung
Die intestinale Stomaanlage ist mit einer nicht zu unterschätzenden Morbidität vergesellschaftet. Eine komplikationsarme Stomaanlage ist Aushängeschild einer Operation und hat unmittelbaren Einfluss auf die Lebensqualität des Patienten. Stomaprobleme, wie Nekrose, Stenose, Retraktion, Prolaps oder peristomale Hernie ebenso wie Probleme mit der Stomaversorgung, gilt es durch korrekte chirurgische Technik zu vermeiden. Dabei machen technische Fehler und Probleme bei der primären Anlage eines Stomas 40 % aller stomabedingten Probleme aus. Dieser Artikel beschreibt Stomatypen und Indikationen, präoperative Vorbereitung und Lokalisation der von uns regelhaft durchgeführten Ileo- und Kolostomien sowie die chirurgische Technik ihrer Anlage. Häufig auftretende Komplikationen und Strategien zu deren Vermeidung werden diskutiert.
Abstract
Surgical creation of an enterosomy is a commonly performed procedure and is associated with high morbidity which often is underestimated. The lack of complications is the only visible mark of this surgical procedure and directly influences the patient's quality of life. Typical problems of enterostomies are necrosis, stenosis, retraction or hernia as well as problems in enterostomy care and should be avoided by correct surgical technique. Technical faults and difficulties in primary enterostomy construction cause 40 % of all enterostomy problems. This article discribes the types of enterostomies, their indication, preoperative plannning and localisation of the site of ileo- and colostomies as well as the surgical technique of their construction. Common complications and strategies of their prevention are discussed.
Schlüsselwörter
Ileostomie - Transversostomie - Kolostomie - chirurgische Technik - Stomaanlage - Komplikationen
Key words
Ileostomy - transverse colostomy - colostomy - surgical technique - stoma-creation - complcations
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Prof. Dr. med. Stefan Post
Direktor der Chirurgischen Klinik, Universitätsklinikum Mannheim
68165 Mannheim
Telefon: +49 (0)621 383-2225
Fax: +49 (0)621 383-3809
eMail: stefan.post@chir.ma.uni-heidelberg.de
