Treatment of recurrent sigmoid volvulus in Parkinson's disease by percutaneous endoscopic colostomy

The exact aetiology of sigmoid volvulus in Parkinson''s disease (PD) remains unclear. A multiplicity of factors may give rise to decreased gastrointestinal function in PD patients. Early recognition and treatment of constipation in PD patients may alter complications like sigmoid volvulus. Treatment of sigmoid volvulus in PD patients does not differ from other patients and involves endoscopic detorsion. If feasible, secondary sigmoidal resection should be performed. However, if the expected surgical morbidity and mortality is unacceptably high or if the patient refuses surgery, percutaneous endoscopic colostomy (PEC) should be considered. We describe an elderly PD patient who presented with sigmoid volvulus. She was treated conservatively with endoscopic detorsion. Surgery was consistently refused by the patient. After recurrence of the sigmoid volvulus a PEC was placed.     

认知干预对结肠造口患者术后造口自我管理的影响研究

目的探讨认知干预对结肠造口患者术后造口自我管理的影响程度,为提高结肠造口患者的生活质量提供依据。方法将2010年8月-2012年7月收治的72例结肠造口患者按住院顺序随机分为对照组和干预组各36例,对照组提供常规的护理及指导,干预组实施认知干预。比较2组患者术后造口的自我管理情况。结果干预组在造口护理方法、造口产品选择、结肠造口认识、对结肠造口焦虑情绪、回归社会信心方面优于对照组,差异均有显著统计学意义(P<0.01)。结论认知干预可提高结肠造口患者术后造口自我管理的能力。     

Secondary coloperineal pull-through and double dynamic graciloplasty after miles resection—feasible, but with a high morbidity

PURPOSE: Until recently, patients who underwent abdominoperineal resections had to cope with a colostomy for the rest of their lives. For some of these patients this colostomy was a terrible burden, physically and mentally. Publications about abdominoperineal pull-through and double dynamic graciloplasty immediately after a Miles resection showed good results. The purpose of this study was to investigate the procedure as a secondary approach after abdominoperineal resections. METHODS: In this study seven patients were evaluated. All had had an abdominoperineal resection and proved to have unbearable problems with their stoma. All had a secondary pull-through and double dynamic graciloplasty, a mean of 8.5 (range, 1.1–34.8) years after the Miles resection. RESULTS: In five patients continence was regained; two were reversed to colostomy because of several complications. Patients who had a successful outcome also suffered from numerous complications, with a total mean hospital stay of 73.8 (range, 27–167) days, a mean of 3.1 (range, 1–6) additional operations, and 1.8 (range, 0–4) readmissions. CONCLUSION: Secondary anorectal reconstruction after abdominoperineal resection is a feasible option, but with a high morbidity. Because of this the procedure was stopped at the beginning of 1997.This study was funded by a grant from the National Fund for Investigational Medicine (Ministry of Health), the Netherlands.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, San Antonio, Texas, May 2 to 7, 1998.     

Critical evaluation of YouTube videos on colostomy and ileostomy: Can these videos be used as learning resources?

ObjectivesWe aimed at identifying and analyzing the accuracy of YouTube videos on colostomy and ileostomy.MethodsYouTube website was searched independently by researchers for videos on colostomy and ileostomy posted before the 18th of May, 2019. Based on predetermined inclusion and exclusion criteria, the videos matching the research objective were identified. Data related to each video were collected, and the videos were categorized using standardized criteria.ResultsA total of 357 videos were identified. Finally, 149 videos were included in the study. Of these, 52 (35%) were educationally useful, and 97 (65%) were not useful. None of the video parameters, including the number of viewers, duration, number of likes or dislikes, days on YouTube or number of comments, was able to differentiate between useful or not useful videos. The score of videos was 14.7 ± 0.6 for valuable videos and 11.0 ± 2.0 for not useful videos (p < 0.001).ConclusionsWhile there were a reasonably number of colostomy and ileostomy videos, there was a smaller number on the surgical procedure. Most non-educational videos were not consistent with clinical guidelines.Practical implicationsYouTube videos on colostomy/ileostomy care can be an important educational resource to patients. However, a collaboration between patients, nurse educators and universities/hospitals is needed to produce high-quality videos.     

老年人低位直肠癌前切除术后回肠置管造口与横结肠造口的对比研究

目的 对比研究回肠置管造口术与横结肠造口术对老年低位直肠癌患者施行前切除术(LAR)后发生吻合口漏的预防和治疗特点.方法 选择低位直肠癌患者施行LAR后具有发生吻合口漏高危因素的老年患者60例,随机分为横结肠造口组与回肠置管造口组.观察吻合口漏的发生率、住院时间和费用.结果 两组各发生吻合口漏1例,均经非手术治疗痊愈.住院时间和费用横结肠造口组为17 d,2.8万元;回肠置管造口组为18 d,2.9万元,两组比较差异无统计学意义(均为P＞0.05).结论 回肠置管造口术对LAR手术后发生吻合口漏的预防和治疗作用与横结肠造口术无差异,是一项简单、安全、有效的方法.     

心理护理和造口护理在直肠癌术后结肠造口患者中的应用效果

目的：探讨心理护理和造口护理在直肠癌术后结肠造口患者中的应用效果。方法选取本院2011年10月~2014年11月诊治的36例直肠癌术后结肠造口患者作为研究对象,随机分为试验组与对照组,各18例。对照组给予遵医用药、病情观察、口头健康宣教、解答患者疑问等常规护理管理,试验组在对照组的基础上加强造口护理和心理护理。比较两组的住院时间、排便不适发生率、排便规律发生率、不良反应发生率及护理满意度。结果试验组的住院时间为(14.68±1.52)d,显著短于对照组的(22.63±1.93)d,差异有统计学意义(P<0.05)。试验组的排便不适发生率显著低于对照组,差异有统计学意义(P<0.05)。试验组的排便规律发生率显著高于对照组,差异有统计学意义(P<0.05)。试验组的不良反应发生率为5.56%,显著低于对照组的33.33%,差异有统计学意义(P<0.05)。试验组的护理满意度为94.44%,显著高于对照组的66.67%,差异有统计学意义(P<0.05)。结论心理护理和造口护理在直肠癌术后结肠造口患者中的应用效果显著,能够有效改善患者的排便状况,降低不良反应发生率,提高护理满意度。     

Aproximación a la vivencia de las personas en el proceso de una colostomía

Objective

The purpose of this paper is to explore the experience of people who go through the process of a colostomy.

Overcoming challenges: life with an ostomy

Background

Studies have demonstrated decreased health-related quality of life in patients with stomas.

Methods

Using US Department of Veterans Affairs electronic medical records, veterans with stomas were surveyed using the City of Hope Quality of Life-Ostomy questionnaire. Focus groups were conducted segregated by type of stoma (ileostomy vs colostomy) and quality-of-life score (high vs low). Qualitative analysis was performed on the basis of the City of Hope Quality of Life for Ostomates format of health-related quality of life (physical, psychological, social, and spiritual). The findings of the colostomy focus groups are reported.

Results

Two new domains emerged: colostomy specific and health care specific. The most common domains discussed were colostomy specific, psychological, and social. The most frequently discussed colostomy-specific theme was effective and ineffective solutions to colostomy care. Family and spousal relationships were the main theme from the psychological category. The predominant social issue was sexual relationships.

Conclusions

Awareness of patients' social, psychological, and medical status allows surgeons to identify those likely to have problems and devote resources to those veterans.     

直肠癌Miles手术后结肠造口的护理

目的探讨护理干预对直肠癌Miles手术后结肠造口患者术后恢复的影响。方法回顾性分析2003年至2009年60例行Miles术的直肠癌病例护理资料。结果60例患者中,术后出现造口缺血1例,造口旁疝1例,造口水肿1例,造口狭窄4例,造口周围皮炎5例。结论直肠癌Miles术后结肠造口的有效护理,可以明显促进患者恢复,提高生活质量。     

经皮内镜引导下盲/结肠造口术治疗溃疡性结肠炎

目的总结经皮内镜引导下盲/结肠造口术(PEC)在治疗溃疡性结肠炎(UC)中的应用体会,探讨PEC的适应证、实施方法及并发症。方法回顾性分析了2009年12月以来2例应用PEC行顺行灌肠治疗UC的实施方法,观察治疗前后UC临床严重程度分级、内镜分级及病理组织学分级变化。结果 2例患者UC临床严重程度分级、内镜分级及病理组织学分级明显好转,无明显并发症。结论应用PEC行顺行灌肠治疗UC是安全、有效的。