enterostomy

The purpose of small intestine ostomy is to infuse enteral nutrition or reduce intestinal pressure. For the purpose of perfusion nutrition, it is advisable to make a stoma in the high intestine. In order to reduce intestinal pressure, the stoma can be made at the proximal end of the small intestine obstruction, or at the proximal end of the small intestine anastomosis to prevent rupture of the anastomosis. The small intestine stoma can also be used to make the feces flow at the proximal end of the lesion. The distal intestine can rest, if the end ileostomy in patients with ulcerative colitis is to allow the colon to rest. In most cases, small intestine ostomy is an additional procedure for other operations in the abdomen. But in a few cases, small intestine ostomy is a separate operation. Small intestine stoma is for intestinal feeding or intestinal decompression. Patients who need to be fed often have malnutrition. Patients who need intestinal decompression often have intestinal obstruction or intestinal inflammatory lesions. Therefore, the abdominal wall incision and the incision can be healed before surgery, and the nutritional status of the patient can be measured. If necessary, parenteral nutrition can be given first. It is important to note that in the case of ascites, the surgery should be carefully performed to prevent the peritoneum of the enterostomy from healing, so that the intestinal fluid overflows from the stoma to the abdominal cavity. Curing disease: Indication When injecting nutrients into the intestine, choose a high stoma; for intestinal insufflation and pumping decompression with a small intestine stoma, and choose the proximal stoma in the obstruction. Contraindications Patients with ascites should use enterostomy carefully to prevent the peritoneum from intestines from healing and forming sputum. Preoperative preparation 1. Correct water, electrolyte and acid-base balance disorders. 2. Strengthen nutrition. Surgical procedure 1. Incision: The left and right rectus abdominis mid-abdominal incision, 2 to 3 cm long, depending on the layer into the abdomen. 2. When using Stamm's intestinal fistula (suitable for short-term sputum), place a section of the intestinal fistula close to the Treitz ligament into the wound and identify the proximal and distal ends. Extrude the contents of the intestine and place the intestinal clamp. Two concentric purse sutures were sutured to the membranous margin using a 2-0 silk thread and sewn to the sarcolemma layer. A small puncture is made on the central wall of the purse, and the selected catheter with a side hole is inserted into the distal intestine. Remove the intestinal forceps. After the inner bag is embedded in the drainage tube, the outer purse re-embeds the drainage tube. The proximal end of the catheter is ejected from the abdominal wall. The intestinal wall around the catheter was fixed to the nearby peritoneum with a 4-pin filament. The catheter is secured to the skin with a silk thread. 3. When using Witzel intestines (suitable for long-term sputum), squeeze out the contents of the small intestines selected for ostomy and place non-pressing forceps. A purse-string suture was applied to the membranous edge using a 2-0 silk thread. A latex tube with a side hole was placed on the intestinal wall, and the suture was sutured at intervals of 1 cm on both sides of the catheter, and the intestinal wall was slightly sewn to form a tunnel of 6 to 8 cm. Then, a small incision is made in the center of the purse, the tip of the catheter is inserted into the small intestine to the required length, and the suture is ligated. The remaining exposed portion of the catheter and the purse of the purse are then embedded with 2 to 4 needles of 2-0 silk. The abdominal wall is made into a puncture, and the pliers are inserted for guiding. The ostomy tube is pulled out of the abdominal wall and sutured between the small intestine and the adjacent peritoneum. The suture area should be wider to prevent the small intestine from twisting or angling.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.