Abstract
Quality of life of ostomates is influenced by subsequent complications and care problems resultmg from carelessness at surgery. Obstacles to implanting a stoma at the optimum site are as follows：1) misdiagnosis on spread of the pathology,2) insufficient preoperative information regarding the stale of the colon proximal to the advanced cancer,3) emergency surgery,4) inflammation,5) severe obesity,6) technical error.
Under the circumstances above,the patients must be treated with great care：1) The optimum site for a stoma has to be established prior to surgery,even in an emergency,whenever the merest possibility exists that a stoma might be necessary. 2) A suitable extent surrounding the optimum site（Fig. 1）and the alternatives proximal to it（Fig. 2）must be observed and marked prior to surgery. A basic misunderstanding on stoma site marking is that a stoma can be implanted at only one point. Stoma site marking consists of locating a suitable area where ostomates can rely on the bag for perfect fitting. 3) Stoma construction should never be considered as an insignificant addendum to removal of the rectum,though it requires no technical difficulty. Bearing the optimum stoma site and the drawing route of colon in mind,the bowel must be divided and implanted straight,but not under tension.
