In order to meet the needs of the disease, a part of the intestine is placed on the surface of the abdomen and opened in the abdominal wall to excrete feces, which is the so-called "enterostomy", commonly known as "artificial".
Let's talk about the characteristics of the small intestine and the large intestine: the small intestine is 5 to 6 meters long and is the most important place for the body to digest and absorb nutrients. The length of the large intestine is generally 15 meters, the main function is to absorb the residual water from the small intestine (equivalent to the dehydration function in the washing machine), and finally expel the feces.
In clinical work, many patients claim that "it is better to let me die than to have a stoma", and they are full of fear of stoma. The refusal of the stoma is usually a patient with low rectal cancer, because the tumor is too low, for the sake of thoroughness of resection, it is impossible to retain **, and the colon can only be lifted from the abdominal wall to make a stoma to divert the stool. These patients are concerned that their body shape has changed, their excretions cannot be controlled at will, and they are troubled by social interaction, diet, odor treatment, ostomy bag use, and other problems, and some people even feel pessimistic and disappointed in life, and lose confidence in the future, so they resolutely refuse to have an ostomy.
Actually, it doesn't have to be this way. At present, there are a variety of stoma bags, ostomy plugs, skin care gels, leak-proof creams, deodorant powders, belts and other care products, which can achieve the effect of collecting feces, protecting **, preventing leakage, and reducing odor, so that ostomy patients can participate in normal social activities and return to work.
For patients with low rectal cancer who are not suitable for anal conservation, an abdominal wall stoma has a better quality of life than barely anal preservation, and an active stoma is much safer than a forced stoma after intestinal obstruction in the advanced stage of the tumor.
l is usually located on the left side of the stomach (lower left abdomen) or on the navel.
l Generally a permanent stoma.
If the stoma can be put back, the surgery is relatively troublesome.
l The feces have been formed and can be discharged once every 1 2 days.
There is a general feeling when you have a bowel movement after l3 months.
l The pouch itself is relatively easy to care for.
l When holding breath suddenly (such as coughing), it is recommended to hold the stoma with the palm of the hand to avoid the prolapse of the intestinal tube or the obvious protrusion of the belly in the stoma area (medically called parastomal hernia, commonly known as "small intestine gas").
l is generally located on the right side of the stomach (right lower abdomen).
l It is generally a temporary stoma and is placed back within 3 to 6 months.
If the stoma is put back, the surgery is relatively easy.
l The stool is completely unformed, basically loose, and has been passed for 24 hours, and even discharges dark green or black bile-like fluid.
l Because there is a lot of fluid loss (similar to watery diarrhea), it is important to drink plenty of water to avoid dehydration; Older people should pay attention to whether the amount of urine per day is reduced or the urine is very dark (if necessary, kidney function is checked).
l The pouch is difficult to care for, and the peristoma** is prone to various rash reactions (specific ostomy outpatient treatment).
l When holding breath suddenly (such as coughing), it is recommended to hold the stoma with the palm of the hand to avoid intestinal prolapse.
l If there is no gas and defecation at the stoma, and there is paroxysmal abdominal pain and bloating, intestinal obstruction is considered, and timely hospital visit is recommended.
l If it is a prophylactic enterostomy after rectal cancer surgery, considering that the stool is not discharged through the rectum**, the corresponding intestinal tube will be apraxia, especially the original rectal anastomosis will be scarred and hyperplasia, so it is recommended that anal examination is required to dilate the anastomosis during the monthly outpatient reexamination after surgery to avoid anastomotic stenosis.
l If it is bowel cancer surgery, it is necessary to determine whether there is tumor metastasis in the abdominal cavity**.
l The distal intestinal tube at the stoma must be examined in many aspects (such as colonoscopy, CT examination after contrast enema, etc.) to ensure that there is no intestinal fistula (especially the original surgical anastomotic leakage), no intestinal stenosis, etc.
l Considering that there are many bacteria in the original stoma, the incision sutured after the stoma is put back is prone to infection, so pay attention to keeping it clean.
l For the prophylactic enterostomy of rectal cancer, after recollection, because the original stool was directly discharged from the body through the small intestine, and now the stool is suddenly discharged from the rectum**, the human body may not be adapted, and fecal incontinence may occur at the beginning (especially for patients who have received radiotherapy), and then repeated bowel movements (may relieve stool more than 20 times a day), see the article "What to do if there are many stools after bowel cancer surgery".
l Considering that the enterostomy is placed back into the abdominal cavity, there is definitely a risk of intestinal anastomosis leakage.
l Consider that the abdominal wall (commonly known as "belly") has undergone a stoma, and the structure of this area is very weak, so try to avoid holding your breath (such as constipation, forced defecation, repeated coughing, weightlifting, etc., when doing these actions, you must pay attention to pressing the incision of the original stoma with the palm of your hand) to avoid local protrusion in the later stage (like a soft small leather bag, the fingers can be partially pressed back, medically called incisional hernia, commonly known as "small intestine gas").