Tsujinaka Shingo, Tan Kok-Yang, Miyakura Yasuyuki, Fukano Rieko, Oshima Mitsuko, Konishi Fumio, Rikiyama Toshiki
Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
J Anus Rectum Colon. 2020 Jan 30;4(1):25-33. doi: 10.23922/jarc.2019-032. eCollection 2020.
Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the "principles of perioperative patient management" section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the "early complications" section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the "late complications" section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre- and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.
造口位置不当、造口管理不善以及造口并发症会导致造口患者的生活质量下降。参与造口创建和/或护理的医疗保健专业人员应具备造口及其并发症管理的基本且最新的知识。这篇综述文章包括以下主要部分：围手术期患者管理原则、早期并发症和晚期并发症。在“围手术期患者管理原则”部分，讨论了术前教育、造口位置标记、术后教育以及患者教育资源的当前概念和趋势。在“早期并发症”部分，我们重点关注了缺血/坏死、液体和电解质失衡、黏膜皮肤分离以及回缩的病因和当前管理方法。在“晚期并发症”部分，我们重点关注了造口旁疝、造口脱垂、造口旁静脉曲张和坏疽性脓皮病的病因和当前管理方法。术前和术后患者教育有助于患者在造口护理方面实现独立并恢复正常活动。医疗保健提供者应具备造口管理及造口并发症的基本技能和最新知识，以便作为造口患者的第一危机处理者。
