Management of adult intestinal stomas: The 2023 French guidelines

IF 2 4区医学 Q2 SURGERY Journal of Visceral Surgery Pub Date : 2024-04-01 DOI:10.1016/j.jviscsurg.2024.02.002

Mathilde Aubert , Etienne Buscail , Emilie Duchalais , Antoine Cazelles , Maxime Collard , Diane Charleux-Muller , Florence Jeune , Alexandre Nuzzo , Alexandra Pellegrin , Luca Theuil , Amandine Toutain , Bertrand Trilling , Laurent Siproudhis , Guillaume Meurette , Jérémie H. Lefevre , Léon Maggiori , Diane Mege , sous l’égide de la Société nationale française de coloproctologie (SNFCP) et de la Société française de chirurgie digestive (SFCD)

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引用次数: 0

Abstract

Aim

Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications.

Methods

A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included.

Results

Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement.

Conclusion

These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.

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成人肠造口病的治疗：2023 年法国指南。

目的：消化道造口手术很常见。法国上一次发布相关指南是在二十年前。我们的目的是更新消化道造口及造口相关并发症围手术期管理的法国临床实践指南：方法：我们对 2000 年 1 月至 2022 年 5 月间发表的法文和英文文章进行了系统性文献回顾。仅考虑了用于成人排粪的消化道造口。儿童造口、泌尿系统造口、用于肠内营养的消化道造口以及罕见造口（Koch造口、会阴造口）均未包括在内：结果：指南包括建立消化道造口的手术地标（理想位置、粘膜吻合、支撑杆的作用、预防性网片的使用）、围手术期临床实践指南（患者教育、术前造口部位标记、术后设备、处方和随访）、早期造口的处理、术后护理和随访、和随访）、造口相关早期并发症的处理（护理困难、高排量、造口坏死、回缩、脓肿和造口周围皮肤并发症）以及造口相关晚期并发症的处理（造口脱垂、造口旁疝、造口狭窄、造口晚期回缩）。每项声明都有一个证据等级：这些指南对临床实践非常有用，可以删除一些过时的教条。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Visceral Surgery SURGERY-

CiteScore

2.00

自引率

9.50%

发文量

108

审稿时长

>12 weeks

期刊介绍： The Journal of Visceral Surgery (JVS) is the online-only, English version of the French Journal de Chirurgie Viscérale. The journal focuses on clinical research and continuing education, and publishes original and review articles related to general surgery, as well as press reviews of recently published major international works. High-quality illustrations of surgical techniques, images and videos serve as support for clinical evaluation and practice optimization. JVS is indexed in the main international databases (including Medline) and is accessible worldwide through ScienceDirect and ClinicalKey.