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[Experiences in the management of patients with ileo- and colostomy (author's transl)].

In the presented paper the management of stoma-patients has been discussed. Two topics had to be seen, first the psychological guidance of the patient and his reentry into society and second the management of the stoma itself. Beside of the sometimes unavoidable complications the patients are often molested by preventable inconviences as skin-irritation, soiling, and odors. New progresses have been made by the development of scentless skin pelottes and adhesive folias. With a new adhesive tissue which avoids the contact between the skin and the adhesive folia we can prevent the skin irritations previously nearly unavoidable.

Aftercare↗

[Creation of a colostomy using a circular mechanical stapler].

The paper describes the method used to create a preternatural anus in terminal stomas using a mechanical circular stapler (Model EEA-31). Two methods are put forward: Chung's and Burke's methods (the latter of which was used by our department). A mechanical circular stapler has been used several times (13) to perform this type of stoma, with excellent esthetic and functional results, both immediate and long-term. It was only necessary to reoperate in one case in order to suspend the affected colic loop.

Colostomy↗

Colostomy.

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Aftercare↗

[Smooth-muscle sphincteroplasty in constructing a colostomy].

A method is described for producing continent colostomal by smooth-muscle sphincteroplasty. There are variants of operative technique: autogenic smooth-muscle intestinal grafting and pediculated plasty. A 10 cm long intestinal segment is split along the free tenia, mucosectomized and wrapped around the precolostomal part of the colon. Essential element of the operation is the 100 per cent stretching of the seromuscular flap when fixed. A tight sphincter-like cuff results. The method is unassociated with specific complications. The first impressions of the sphincteroplasty with encouraging results are recorded. In cases when no sphincter effect was obtained there was inadequacy in some elements of the operation. Then the stoma functions as a conventional one.

Colostomy↗