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<p>Stoma creation has evolved from a&#xa0;historical last resort intervention to a&#xa0;standardized, elective key procedure in colorectal surgery. When performed correctly, modern ostomy treatment systems can substantially improve health-related quality of life. Nevertheless, stomas remain associated with complication rates of 20–50% and considerable psychosocial and health-economic burdens. A&#xa0;“good” stoma is tension-free, in a transrectal position, with a&#xa0;prominence of 2–3 cm, allowing an air-tight and fluid-tight, skin-sparing seal and being easily visible and manageable for patients, whereas a&#xa0;technically inadequate stoma is often not amenable to satisfactory revision. Preoperative stoma site selection and marking with the patient in standing, sitting and flexed positions, combined with structured stoma care input, significantly reduce stoma-related complications and improve adherence and quality of life. Technically decisive are a&#xa0;tension-free transrectal passage, an aperture of approximately 25 mm, sufficient prominence and a&#xa0;standardized enterocutaneous anastomosis using inverting intradermal-extramucosal atraumatic sutures with monofilament, absorbable material. For permanent end stomas, preoperative and postoperative abdominal wall strengthening programs and prophylactic mesh reinforcement should be offered whenever feasible, while stoma bridges, fascio-enteric sutures and classical keyhole or Sugarbaker techniques lack evidence of benefit. In addition, explicit consideration of psychosocial and cultural factors exerts a&#xa0;protective effect on acceptance, self-management and health-related quality of life.</p>

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Stomaanlage

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月22日

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  • Skander Bouassida,
  • Till Lunenburg,
  • Tom Schefter,
  • Caroline Busch,
  • Ulrich Adam

摘要

Stoma creation has evolved from a historical last resort intervention to a standardized, elective key procedure in colorectal surgery. When performed correctly, modern ostomy treatment systems can substantially improve health-related quality of life. Nevertheless, stomas remain associated with complication rates of 20–50% and considerable psychosocial and health-economic burdens. A “good” stoma is tension-free, in a transrectal position, with a prominence of 2–3 cm, allowing an air-tight and fluid-tight, skin-sparing seal and being easily visible and manageable for patients, whereas a technically inadequate stoma is often not amenable to satisfactory revision. Preoperative stoma site selection and marking with the patient in standing, sitting and flexed positions, combined with structured stoma care input, significantly reduce stoma-related complications and improve adherence and quality of life. Technically decisive are a tension-free transrectal passage, an aperture of approximately 25 mm, sufficient prominence and a standardized enterocutaneous anastomosis using inverting intradermal-extramucosal atraumatic sutures with monofilament, absorbable material. For permanent end stomas, preoperative and postoperative abdominal wall strengthening programs and prophylactic mesh reinforcement should be offered whenever feasible, while stoma bridges, fascio-enteric sutures and classical keyhole or Sugarbaker techniques lack evidence of benefit. In addition, explicit consideration of psychosocial and cultural factors exerts a protective effect on acceptance, self-management and health-related quality of life.