Keywords: stoma, stoma care, care pathways, continuity recovery

"Challenges in stoma surgery and patient management"

There are approximately 32,000 stoma patients in the Netherlands and approximately 7,000 new stomas are placed each year. Having a stoma has a major impact on a patient's mental and physical health and well-being. In addition, stoma operations are associated with a high risk of complications. It is therefore important to know which patient groups benefit from a stoma and which patient groups only experience disadvantages. This dissertation has investigated 1) specific patient groups undergoing emergency surgery, 2) elderly patients who underwent surgery for colon and rectal cancer and 3) patients after rectal cancer surgery. In addition, it was investigated how stoma patients can best be guided in the form of patient education and care pathways, in order to reduce readmissions and the need for home care. Finally, a new technique for lifting a stoma through the stoma opening itself (single-port) was examined. This method turned out to be just as safe and associated with fewer complications compared to the classic open surgery method. With the help of these studies, this dissertation hopes to provide physicians with more information in the decision-making process of who benefits or does not benefit from a stoma, how to eliminate a stoma and what the effects are of good patient education and care pathways for stoma patients.

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