Abstract | Kolostoma je grčka riječ sastavljena od dvije riječi, gdje colon znači debelo crijevo, a stoma otvor ili usta. To označava kirurški otvor gdje je debelo crijevo izvedeno na prednju stijenku abdomena te predstavlja novi izlaz za stolicu. Kolostoma se izvodi u općoj anesteziji prilikom operativnog zahvata. Postoje dva načina pristupa operativnom polju: laparaskopija i laparatomija. Prema trajanju, kolostoma može biti kratkotrajna ili trajna ovisno o uzroku bolesti. Prema mjestu, kolostoma može biti uzlazna, poprečna, silazna i sigmoidna.
Najčešći razlozi za izvođenje privremene kolostome su: opstrukcija debelog crijeva, urođene anomalije, karcinomi debelog crijeva, traume, upalne bolesti debelog crijeva te jatrogena perforacija crijeva endoskopom.
Glavni razlog za kreiranje privremene stome je karcinom debelog crijeva. Drugi je po pojavnosti i smrtnosti od zloćudnih novotvorina kod muškaraca i žena. Najčešći simptomi kod raka debelog crijeva su: pojava krvi u stolici, nadutost, gubitak težine u kratkom vremenskom periodu, pojava umora i slabosti.
Vrlo je bitna psihička i fizička priprema bolesnika prije operativnog zahvata da bi se prevenirale poslijeoperacijske poteškoće i komplikacije. Nakon operativnog zahvata, vrlo je bitna edukacija pacijenta za daljnji nastavak njege privremene stome u kućnim uvjetima. Također, naglasak treba staviti na prehranu, zbog veće osjetljivosti na određene namirnice.
Pacijentima uvelike pomaže razgovor sa bližom obitelji, liječnikom, enterostomalnim terapeutom i prijateljima. Svaki pacijent ima pravo na besplatnu upotrebu stoma pomagala koja se prema Pravilniku ortopedskih pomagala uručuje besplatno po odlasku iz bolnice. Bez obzira na dob i spol, svi osiguranici, nakon složenog operativnog zahvata koji zahtjeva previjanje rane i skrb za stomu, imaju pravo na zdravstvenu njegu u kući. |
Abstract (english) | Colostoma is a Greek word made up of two words, where colon means colon, and stoma means opening or mouth. This marks the surgical opening where the colon is performed on the anterior abdominal wall and represents a new outlet for the stool. The colostomy is performed under general anesthesia during surgery. There are two ways to approach the operative field: laparoscopy and laparotomy. Depending on the duration, a colostomy can be short-lived or permanent depending on the cause of the disease. Depending on the site, the colostomy can be ascending, transverse, descending, and sigmoid.
The most common reasons for performing a temporary colostomy are: colon obstruction, congenital anomalies, colon cancer, trauma, inflammatory bowel disease, and iatrogenic bowel perforation with an endoscope.
The main reason for creating a temporary stoma is colon cancer. It is second in incidence and mortality from malignant neoplasms in men and women. The most common symptoms of colon cancer are: the appearance of blood in the stool, bloating, weight loss in a short period of time, the appearance of fatigue and weakness.
Psychological and physical preparation of patients before surgery is very important in order to prevent postoperative difficulties and complications. After the operation, it is very important to educate the patient to continue the care of temporary stoma at home. Also, emphasis should be placed on diet, due to greater sensitivity to certain foods.
Patients are greatly helped by talking to close family, a doctor, an enterostomal therapist, and friends. Every patient has the right to free use of stoma aids, which according to the Regulations of Orthopedic Aids are delivered free of charge upon departure from the hospital. Regardless of age and gender, all insured persons, after a complex surgical procedure that requires wound dressing and stoma care, are entitled to home health care. |