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Intestinal Ostomies

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Colon Polyps and Colorectal Cancer

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Abstract

A stoma is an intentional anastomosis between a part of the gastrointestinal system and cutaneous tissue of anterior abdominal wall. Indications may include miscellaneous causes such as relieving a distal obstruction and diversion of fecal flow away from a distal anastomosis. Preoperative stoma siting promotes self-care, reduces stoma-related complications, and improves postoperative quality of life. A stoma can be end-on or loop. Modern stoma construction is more frequently done by minimally invasive techniques. For ulcerative colitis patients with a desire to preserve physiologic defecatory function who are not candidates for ileal pouch-anal anastomosis, continence ileostomy can be an option. In enterostomies with high output, loss of enteral contents can lead to dehydration, electrolyte abnormalities, vitamin deficiencies, and malnutrition. Patients with high output ostomies are managed with oral and intravenous fluid and electrolyte replacement, vitamin replacement, restriction of hypotonic fluids, anti-peristaltic and anti-secretory medications. Incidence of stomal complications is between 14% and 79%. They may occur in the early postoperative period or years after the construction of stoma. The most common complication is peristomal skin irritation. Parastomal hernia, stomal stenosis, retraction, bleeding, and prolapse are among the other complications that can be encountered commonly.

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Authors and Affiliations

  1. General Surgery Department, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey

    Bulent Calik, Ayberk Dursun, Semra Demirli & Huseyin Esin

  2. Intensive Care Department, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Izmir, Turkey

    Huseyin Toptay

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  1. Bulent Calik
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  1. Department of Surgery, Izmir Tepecik Training and Research Hospital, Konak, Izmir, Turkey

    Omer Engin

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Calik, B., Toptay, H., Dursun, A., Demirli, S., Esin, H. (2021). Intestinal Ostomies. In: Engin, O. (eds) Colon Polyps and Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-57273-0_19

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