Abstract：
OBJECTIVE: 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.
CONCLUSIONS: These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.
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.
CONCLUSIONS: These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.
摘要：
目的：经常进行消化造口。最近的法国指南已经在20年前发布了。我们的目的是更新法国临床实践指南，以指导消化造口和造口相关并发症的围手术期管理。
方法：对2000年1月至2022年5月之间发表的法语和英语文章进行了系统的文献综述。仅考虑了用于成人粪便排出的消化造口。儿童造口，尿道造口,用于肠内营养的消化造口，和罕见的气孔(科赫，会阴）不包括在内。
结果：指南包括创建消化造口的手术标志（理想位置，粘膜皮肤吻合,支撑杆的效用，使用预防性网状物)，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,和后续行动)，早期造口相关并发症的管理(护理困难，高输出，造口坏死,撤回,脓肿和造口周围皮肤并发症)，以及晚期造口相关并发症的管理(造口脱垂，造口旁疝,造口狭窄,晚期造口回缩)。每个陈述都分配了一个级别的证据。
结论：这些指南在临床实践中非常有用，并允许删除一些过时的教条。
方法：对2000年1月至2022年5月之间发表的法语和英语文章进行了系统的文献综述。仅考虑了用于成人粪便排出的消化造口。儿童造口，尿道造口,用于肠内营养的消化造口，和罕见的气孔(科赫，会阴）不包括在内。
结果：指南包括创建消化造口的手术标志（理想位置，粘膜皮肤吻合,支撑杆的效用，使用预防性网状物)，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,和后续行动)，早期造口相关并发症的管理(护理困难，高输出，造口坏死,撤回,脓肿和造口周围皮肤并发症)，以及晚期造口相关并发症的管理(造口脱垂，造口旁疝,造口狭窄,晚期造口回缩)。每个陈述都分配了一个级别的证据。
结论：这些指南在临床实践中非常有用，并允许删除一些过时的教条。
