关键词: 肠造口, 造口定位, 预防性造口, 造口旁疝, 腹膜外造口, 补片

Abstract: Standardized ostomy and preventive strategy of parastomal hernia        LOU Zheng，ZHANG Wei. Department of Colorectal Surgery，the First Affiliated Hospital，Navy Medical University，Shanghai 200433，China
Corresponding author：ZHANG Wei，E-mail：weizhang2000cn@163.com
Abstract    Stoma plays an important role in the treatment of benign and malignant colorectal diseases and trauma. Standardized ostomy is the key point to reducing the complications of stoma and improving the quality of life. The surgeon should hold the concept that stoma is the anastomosis between the intestine and the skin. Before an operation，the surgeon，the stoma therapist，the patient and their families should decide the stoma location. Individual risk factors must be evaluated to determine whether a protective stoma should be done. The standardized ostomy should include reasonable choice of stoma location，appropriate size of abdominal incision，appropriate width of abdominal wall channel，appropriate external height of stoma and good suture between stoma bowel and various layers of abdominal wall. Parastomal hernia is the most common long-term complication of the stoma. Women，obesity and diabetes are common risk factors for parastomal hernia. Many studies have shown that extraperitoneal stoma and preventive mesh placement can reduce the incidence of parastomal hernia.

Key words: ostomy, stoma location, protective stoma, parastomal hernia, extraperitoneal ostomy, mesh