Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Pub...Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Published literature on psychological pain in enterostomy patients was retrieved from Chinese and English databases, including CNKI, Wanfang, VIP, China Biomedical Network, PubMed, Embase, Ovid, and Web of Science. The search period covered the establishment of the databases until October 2024. Literature was screened based on inclusion and exclusion criteria, and its quality was evaluated. Data analysis was performed using R Studio software. Results: A total of 2,237 articles involving 1,221 patients with enterostomy and 11 influencing factors were identified. The results of the meta-analysis indicated that age, marital status, ostomy complications, self-care ability, pain severity, and sleep quality were the primary contributors to psychological distress. Conclusion: Multiple factors influence psychological pain in enterostomy patients. Medical staff should prioritize addressing these factors to alleviate psychological pain and enhance patients’ quality of life.展开更多
From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical s...From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical staff,early detection of risk factors and formulation of personalized intervention measures.展开更多
BACKGROUND A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease(HD)due to its superior cosmetic results.One-stage transanal ...BACKGROUND A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease(HD)due to its superior cosmetic results.One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications.However,enterostomy is required in some HD cases for enterocolitis and dilated colon.Our transumbilical enterostomy(TUE)and twostage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation,but the effect in patients with HD is unclear.AIM To evaluate the safety,efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD.METHODS From June 2013 to June 2018,53 patients(40 boys,13 girls;mean age at enterostomy:5.5±2.2 mo)who underwent enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution.Two enterostomy approaches were used:TUE in 24 patients,and conventional abdominal enterostomy(CAE)in 29 patients.Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon.26 patients had long-segment HD,and 16 patients had total colonic aganglionosis(TCA).The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure,and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure.Demographics,enterostomy operative time,complications and cosmetic results were respectively evaluated.RESULTS There were no differences between the groups with respect to gender,age at enterostomy,weight and clinical type(P>0.05).No conversion to open technique was required.Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group(8.33%vs 3.45%,P>0.05).No parastomal hernia was observed in either of the two groups.Wound infection at the stoma was seen in 1 case in the TUE group,and 2 cases in the CAE group(4.17%vs 6.90%,P>0.05).No obstruction was noted in any of the patients in the TUE group,whereas obstruction was found in 1 patient in the CAE group.Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group,respectively(12.50%vs 17.24%,P>0.05).There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation(P>0.05).The cosmetic result using the scar score in the TUE group was better than that in the CAE group(6.83±0.96 vs 13.32±1.57,P<0.05).CONCLUSION TUE is a safe and feasible method for the treatment of HD,and the staged enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure.展开更多
Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial que...Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.展开更多
BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the ...BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.展开更多
BACKGROUND Mucocutaneous separation(MCS)is a common postoperative complication in enterostomy patients,potentially leading to significant morbidity.Early identification of risk factors is crucial for preventing this c...BACKGROUND Mucocutaneous separation(MCS)is a common postoperative complication in enterostomy patients,potentially leading to significant morbidity.Early identification of risk factors is crucial for preventing this condition.However,predictive models for MCS remain underdeveloped.AIM To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.METHODS A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study.Patients were divided into two groups,the MCS group(n=110),and the non-MCS(n=382)based on the occurrence of MCS within the first 3 weeks after surgery.Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed.Receiver operating characteristic curve analysis was used to assess the model’s performance.RESULTS The postoperative MCS incidence rate was 22.4%.Suture dislodgement(P<0.0001),serum albumin level(P<0.0001),body mass index(BMI)(P=0.0006),hemoglobin level(P=0.0409),intestinal rapture(P=0.0043),incision infection(P<0.0001),neoadjuvant therapy(P=0.0432),stoma site(P=0.0028)and elevated intra-abdominal pressure(P=0.0395)were potential predictive factors of MCS.Suture dislodgement[P<0.0001,OR:28.007595%CI:(11.0901-82.1751)],serum albumin level(P=0.0008,OR:0.3504,95%CI:[0.1902-0.6485]),BMI[P=0.0045,OR:2.1361,95%CI:(1.2660-3.6235)],hemoglobin level[P=0.0269,OR:0.5164,95%CI:(0.2881-0.9324)],intestinal rapture[P=0.0351,OR:3.0694,95%CI:(1.0482-8.5558)],incision infection[P=0.0179,OR:0.2885,95%CI:(0.0950-0.7624)]and neoadjuvant therapy[P=0.0112,OR:1.9769,95%CI:(1.1718-3.3690)]were independent predictive factors and included in the model.The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.CONCLUSION The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients.展开更多
The psychosocial disorder of patients with enterostomy is still a huge challenge for the health systems.Acceptance and Commitment Therapy(ACT)has shown good results in permanent enterostomy in recent years.This paper ...The psychosocial disorder of patients with enterostomy is still a huge challenge for the health systems.Acceptance and Commitment Therapy(ACT)has shown good results in permanent enterostomy in recent years.This paper explores the current status regarding ACT for patients with enterostomy in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.The study concludes that as a new psychological intervention method,ACT can significantly reduce the negative emotions and complications of patients with enterostomy,and improve their psychological flexibility,stoma acceptance,psychosocial adaptability,self-care ability and quality of life.展开更多
AIM:To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant bowel.METHODS:We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior me...AIM:To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant bowel.METHODS:We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO); the patients were divided into a delayed closure group (D group) and an early closure group (E group).RESULTS:The mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 ± 2.1 d) than in the D group (34.3 ± 5.9 d) (P < 0.0001). The duration of hospitalization after surgery was significantly shorter in the E group (33 ± 2.2 d) than in the D group (51 ± 8.9 d) (P < 0.0002).CONCLUSION:Endoscopic examination of blood flow and edema in the remnant bowel is useful to assess the feasibility of early closure of enterostomy in SMAO cases.展开更多
Aim: Incarcerated stomal prolapse is a rare complication of enterostomy. Numerous procedures have been described, such as additional laparotomy to fix the intraabdominal intestine in place, enterostomy revision, or co...Aim: Incarcerated stomal prolapse is a rare complication of enterostomy. Numerous procedures have been described, such as additional laparotomy to fix the intraabdominal intestine in place, enterostomy revision, or correction of the prolapse following stoma creation. The authors report successful managements by stomal reconstruction and discuss several clinical points, including the techniques of surgical revision for incarcerated stomal prolapse in loop enterostomy. Patients: Case 1) A female infant weighing 2755 g was delivered at 34 weeks of gestation. On the first day after birth, a right supra-abdominal transverse incision of 10 cm in diameter was used for transverse loop colostomy in a cloacal malformation. Two centimeters of the stomal loop was approximated with sutures to prevent evisceration of the small intestine between the 2 limbs of the loop. Interrupted sutures of 5-0 absorbable monofilament secured the seromuscle of the colon to the peritoneum and fascia, and also to the skin. The distal limb of the colostomy prolapsed 11 months after birth. The physical findings revealed that 10 cm of the distal limb was intussuscepted. Case 2) A female infant weighing 2550 g was delivered at 39 weeks of gestation. A radiological examination by contrast enema showed no spastic rectum and colon, as in Hirschsprung’s disease. Under the laparotomy of a right supra-abdominal transverse incision of 5 cm in diameter, loop ileostomy was performed at 30cm on the proximal side of the cecum such as Case 1. Subsequently, the proximal limb of the ileostomy prolapsed 2 days after operation. The physical findings revealed that 10 cm of the proximal limb was intussuscepted. New enterostomy formation: Divided enterostomy was performed with 3-cm stitching of each limb. The stomal site was moved to the inside from the previous stomal site to oversew and fix by the rectal fascia. The children have been well without trouble since undergoing the new eneterostomy formation. Conclusions: Operation to repair the prolapse of a stoma is advised if it causes problems. We found that simple mobilization of the bowel and excision of the redundant bowel provided a satisfactory result in the present cases.展开更多
Objective:To discuss the research status of self-care agency assessment and intervention of enterostomy patients at home and abroad,and to provide reference for medical staff to understand the defects and needs of sel...Objective:To discuss the research status of self-care agency assessment and intervention of enterostomy patients at home and abroad,and to provide reference for medical staff to understand the defects and needs of self-care agency of enterostomy patients and implement effective intervention.Methods:By searching the literature comprehensively,the latest research progress of self-care agency assessment and intervention of enterostomy patients at home and abroad was summarized.Results:The self-care agency assessment tools for patients with enterostomy included Stoma Self-Care Scale(SSCS),Specific Self-Care for Ostomized Patients Questionnaire(CAESPO)and Self-Care Competence of the Person with an Intestinal Stoma:Nursing School of Porto(CAO-EI:ESEP).Interventions included extended care,educational intervention and multidisciplinary team nursing.Conclusion:The concept of renewal should be used to evaluate the self-care agency of enterostomy patients from various aspects.In the future,we should actively carry out standardized research on the content and time of extended nursing and educational intervention,promote the extensive and standardized implementation of multidisciplinary team nursing,and promote the comprehensive improvement of self-care agency of enterostomy patients.展开更多
Objective: To explore the clinical significance of “3H” nursing mode in improving negative emotions and insomnia in patients with enterostomy through a prospective cohort study. Methods: Adult patients who underwent...Objective: To explore the clinical significance of “3H” nursing mode in improving negative emotions and insomnia in patients with enterostomy through a prospective cohort study. Methods: Adult patients who underwent enterostomy surgery in our gastroenterology department with negative emotions and insomnia between August 2021 and August 2022 were selected as research objects and randomly divided into “3H” nursing mode group and conventional nursing management group. For the conventional nursing group, routine standard nursing mode was adopted after enterostomy, while extra systematic “3H” nursing service on the basis of conventional nursing management was applied for its counterpart. SAS and SDS scores, Pittsburgh sleep quality index, Barthel index and nursing satisfaction were compared between the two groups. Results: SAS and SDS scores, Pittsburgh sleep quality index, Barthel index and nursing satisfaction of “3H” nursing mode group were evidently better than those of conventional nursing management group, and the difference was significant (P Conclusion: The “3H” nursing mode can effectively improve negative emotions of patients with enterostomy, such as anxiety and depression, improve their sleep quality and self-care ability in daily life, and play an important role in building a harmonious relationship between doctors and patients, nurses and patients, which is worthy of clinical application.展开更多
Aims:The study aimed to comprehensively search the systematic reviews and meta-analyses on quality of life in colorectal cancer patients with enterostomy in China and strictly evaluate the reporting quality,to promote...Aims:The study aimed to comprehensively search the systematic reviews and meta-analyses on quality of life in colorectal cancer patients with enterostomy in China and strictly evaluate the reporting quality,to promote the clinical transformation and implementation of evidence-based evidence on quality of life in colorectal cancer patients with enterostomy.Method:Cnki,Wanfang and VIP databases were comprehensively searched from the database construction to September 15,2021,to find the meta-analyses on quality of life in colorectal cancer patients with enterostomy in China.We used the PRISMA statement to evaluate their reporting quality rigorously.Results:9 articles were included in this study.Their PRISMA scores ranged from 18 to 24,with an average score of 20.44.The reporting rate of PRISMA in 9 articles was 70.37%to 88.89%.The 27 PRISMA items had a 0-100%reporting rate.Conclusion:The reporting quality of meta-analyses on quality of life in colorectal cancer patients with enterostomy in China is ideal.However,there are still 8 PRISMA items with a reporting rate of less than 70%,which need to be further improved in future research.展开更多
Objective: To evaluate the effect of stoma comprehensive nursing in reducing postoperative complications of newborn enterostomy. Methods: from October 2018 to March 2020, 84 newborns undergoing enterostomy in our hosp...Objective: To evaluate the effect of stoma comprehensive nursing in reducing postoperative complications of newborn enterostomy. Methods: from October 2018 to March 2020, 84 newborns undergoing enterostomy in our hospital were included in the study. All the subjects were randomly divided into control group (n = 42, routine nursing) and experimental group (n = 42, stoma comprehensive nursing). The postoperative complications and use time of ostomy bag of the two groups were compared. Results: compared with newborns in the control group, the total incidence of postoperative complications in the experimental group was lower, and the use time of ostomy bag was longer, with significant differences (P < 0.05). Conclusion: the application of stoma comprehensive nursing for newborn enterostomy has ideal effect, can prolong the use time of ostomy bag, and reduce the incidence of postoperative complications, which is worthy of wide application.展开更多
Objective: to explore the application of family-centered nursing in children with enterostomy during perioperative period. Methods: 100 cases of patients with pediatric enterostomy in our hospital from August 2019 to ...Objective: to explore the application of family-centered nursing in children with enterostomy during perioperative period. Methods: 100 cases of patients with pediatric enterostomy in our hospital from August 2019 to August 2020 were collected and randomly divided into two groups. The control group received routine nursing, and the observation group received family-centered nursing. The length of stay and the incidence of enterostomy complications were compared between the two groups. Results: the hospitalization time of the observation group was shorter than that of the control group, and the incidence of enterostomy complications was lower than that of the control group, with significant difference (P < 0.05). Conclusion: the application effect of family-centered nursing in the period of enterostomy perioperative of children is accurate, which can reduce the complications of enterostomy, shorten the length of hospital stay. And it is the continuing nursing mode that is worthy of popularizing and applying.展开更多
According to the causes of enterostomy fecal dermatitis, the corresponding nursing countermeasures were adopted. Through strengthening the prevention, identify the existing skin lesions and actively treat them, and co...According to the causes of enterostomy fecal dermatitis, the corresponding nursing countermeasures were adopted. Through strengthening the prevention, identify the existing skin lesions and actively treat them, and comprehensively apply the cooperative care, evidence-based care and continuing care to the patients with enterostomy. It can effectively prevent the occurrence of enterostomy fecal dermatitis, accelerate the recovery of damaged skin, reduce the pain of patients, and improve living quality of patients. It has a significant clinical effect.展开更多
The purpose of this article is to explain the important significance of telemedicine continuous care for patients after enterostomy. In the demonstration process, 176 patients who had undergone enterostomy were select...The purpose of this article is to explain the important significance of telemedicine continuous care for patients after enterostomy. In the demonstration process, 176 patients who had undergone enterostomy were selected. During hospitalization, the patients were taught how to observe and care for stomostomy correctly, how to use dung bags correctly and how to soothe their anxiety under the professional demonstration of doctors and nurses, laying a good foundation for post-discharge nursing. After discharge, when patients encounter problems after ostomy, they can use information methods, such as wechat video, voice phone, wechat group, QQ group and other ways to seek help from doctors and experts for remote continuing care. After discharge, 134 of the 176 patients had discomfort with ostomy and postoperative complications. They chose convenient information methods to seek help. After the remote guidance of doctors, 98 patients handled ostomy problems at home according to the guidance of doctors, and their self-resolution rate reached 73.13%. Therefore, it is concluded that the remote continuing care in an information-based way can improve the ability of patients to solve postoperative problems by themselves.展开更多
BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children ...BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.METHODS One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group.The control group(60 cases)received traditional telephone follow-up for continuity of care,while the study group(60 cases)used a visualization mobile terminal-based care model.The incidence of stoma-related complications,caregiver burden scale,and competence scores of children with stoma were compared between the two groups.RESULTS The primary caregiver burden score in the study group(37.22±3.17)was significantly lower than that in the control group(80.00±4.47),and the difference was statistically significant(P<0.05).Additionally,the caregiving ability score of the study group(172.08±3.49)was significantly higher than that of the control group(117.55±4.28;P<0.05).The total incidence of complications in the study group(11.7%,7/60)was significantly lower compared to the control group(33.3%,20/60;χ2=8.086,P=0.004).CONCLUSION The visual mobile terminal-based care model reduces caregiver burden,improves home care ability,lowers the incidence of complications and readmission rates,and supports successful second-stage reduction surgery for children with enterostomies.展开更多
AIM To evaluate the occurrence and severity of enterostomy complications in newborns suffering from different intestinal disorders.METHODS A 10-year retrospective cohort study(2008-2017) investigated newborns that und...AIM To evaluate the occurrence and severity of enterostomy complications in newborns suffering from different intestinal disorders.METHODS A 10-year retrospective cohort study(2008-2017) investigated newborns that underwent enterostomy formation and reversal for different intestinal disorders. Only infants less than 28 d old at the time of enterostomy creation were included in the study(corrected age was applied in the cases of preterm neonates). The patients were divided into two groups according to their underlying diseases. Group 1 included infants suffering from necrotizing enterocolitis(NEC), whereas Group 2 included newborns diagnosed with intestinal disorders other than NEC, such as meconium obstruction, anorectal malformation, focal intestinal perforation, ileus, intestinal atresia and volvulus. The primary outcome measure was enterostomy-related morbidity. The data were analyzed statistically using Pearson's χ2 test or Fisher's exact test for categorical variables and the Wilcoxon-Mann-Whitney U-Test for continuous variables. RESULTS In total, 76 infants met the inclusion criteria and were evaluated for enterostomy-related complications. Neither group showed significant differences regarding gender, gestational age, weight at birth or weight at enterostomy formation. Infants suffering from NEC(Group 1) were significantly older at enterostomy for-mation than the neonates of Group 2 [median(range), 11(2-75) d vs 4(1-101) d, P = 0.004)]. Significantly more ileostomies were created in Group 1 [47(92.2%) vs 16(64.0%), P = 0.007], whereas colostomies were performed significantly more often in Group 2 [2(3.9%) vs 8(32.0%), P = 0.002]. The initiation of enteral nutrition after enterostomy was significantly later in Group 1 infants than in Group 2 infants [median(range), 5(3-13) vs 3(1-9), P < 0.001]. The overall rate of one or more complications in patients of both groups after enterostomy formation was 80.3%, with rates of 86.3% in Group 1 and 68.0% in Group 2(P = 0.073). Most patients suffered from two complications(23.7%). Four or more complications occurred in 21.6% of the infants in Group 1 and in 12.0% of the infants in Group 2(P = 0.365). Following enterostomy closure, at least one complication was observed in 26.0% of the patients(30.6% in Group 1 and 16.7% in Group 2, P = 0.321). The occurrence of complications was not significantly different between neonates with NEC and infants with other intestinal disorders. 48(65.8%) patients required no treatment or only pharmacological treatment for the complications that occurred [Clavien-Dindo-Classification(CDC) < Ⅲ], while 25(34.2%) required surgery to address the complications(CDC ≥Ⅲ). Early reversal of the enterostomy was performed significantly more often(P = 0.003) and the time to full enteral nutrition after closure was significantly longer [median(range), 7(3-87) d vs 12(5-93) d, P = 0.006] in infants with a CDC grading ≥Ⅲ than in infants with a CDC grading < Ⅲ. CONCLUSION Complications occur in almost all infants with enterostomies. The majority of these complications are minor and do not require surgical treatment. There is a clear trend that neonates with NEC have a higher risk for developing complications than those without NEC.展开更多
文摘Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Published literature on psychological pain in enterostomy patients was retrieved from Chinese and English databases, including CNKI, Wanfang, VIP, China Biomedical Network, PubMed, Embase, Ovid, and Web of Science. The search period covered the establishment of the databases until October 2024. Literature was screened based on inclusion and exclusion criteria, and its quality was evaluated. Data analysis was performed using R Studio software. Results: A total of 2,237 articles involving 1,221 patients with enterostomy and 11 influencing factors were identified. The results of the meta-analysis indicated that age, marital status, ostomy complications, self-care ability, pain severity, and sleep quality were the primary contributors to psychological distress. Conclusion: Multiple factors influence psychological pain in enterostomy patients. Medical staff should prioritize addressing these factors to alleviate psychological pain and enhance patients’ quality of life.
文摘From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical staff,early detection of risk factors and formulation of personalized intervention measures.
基金Supported by the Public Welfare Research and Special Fund of the National Health and Family Planning of China,No.201402007
文摘BACKGROUND A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease(HD)due to its superior cosmetic results.One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications.However,enterostomy is required in some HD cases for enterocolitis and dilated colon.Our transumbilical enterostomy(TUE)and twostage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation,but the effect in patients with HD is unclear.AIM To evaluate the safety,efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD.METHODS From June 2013 to June 2018,53 patients(40 boys,13 girls;mean age at enterostomy:5.5±2.2 mo)who underwent enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution.Two enterostomy approaches were used:TUE in 24 patients,and conventional abdominal enterostomy(CAE)in 29 patients.Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon.26 patients had long-segment HD,and 16 patients had total colonic aganglionosis(TCA).The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure,and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure.Demographics,enterostomy operative time,complications and cosmetic results were respectively evaluated.RESULTS There were no differences between the groups with respect to gender,age at enterostomy,weight and clinical type(P>0.05).No conversion to open technique was required.Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group(8.33%vs 3.45%,P>0.05).No parastomal hernia was observed in either of the two groups.Wound infection at the stoma was seen in 1 case in the TUE group,and 2 cases in the CAE group(4.17%vs 6.90%,P>0.05).No obstruction was noted in any of the patients in the TUE group,whereas obstruction was found in 1 patient in the CAE group.Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group,respectively(12.50%vs 17.24%,P>0.05).There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation(P>0.05).The cosmetic result using the scar score in the TUE group was better than that in the CAE group(6.83±0.96 vs 13.32±1.57,P<0.05).CONCLUSION TUE is a safe and feasible method for the treatment of HD,and the staged enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure.
文摘Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.
基金the Natural Science Foundation of Shandong Province,No.ZR2020MH257。
文摘BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.
基金Supported by the Zhejiang Province Medical and Health Science and Technology Plan Project,No.2022KY1427.
文摘BACKGROUND Mucocutaneous separation(MCS)is a common postoperative complication in enterostomy patients,potentially leading to significant morbidity.Early identification of risk factors is crucial for preventing this condition.However,predictive models for MCS remain underdeveloped.AIM To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.METHODS A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study.Patients were divided into two groups,the MCS group(n=110),and the non-MCS(n=382)based on the occurrence of MCS within the first 3 weeks after surgery.Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed.Receiver operating characteristic curve analysis was used to assess the model’s performance.RESULTS The postoperative MCS incidence rate was 22.4%.Suture dislodgement(P<0.0001),serum albumin level(P<0.0001),body mass index(BMI)(P=0.0006),hemoglobin level(P=0.0409),intestinal rapture(P=0.0043),incision infection(P<0.0001),neoadjuvant therapy(P=0.0432),stoma site(P=0.0028)and elevated intra-abdominal pressure(P=0.0395)were potential predictive factors of MCS.Suture dislodgement[P<0.0001,OR:28.007595%CI:(11.0901-82.1751)],serum albumin level(P=0.0008,OR:0.3504,95%CI:[0.1902-0.6485]),BMI[P=0.0045,OR:2.1361,95%CI:(1.2660-3.6235)],hemoglobin level[P=0.0269,OR:0.5164,95%CI:(0.2881-0.9324)],intestinal rapture[P=0.0351,OR:3.0694,95%CI:(1.0482-8.5558)],incision infection[P=0.0179,OR:0.2885,95%CI:(0.0950-0.7624)]and neoadjuvant therapy[P=0.0112,OR:1.9769,95%CI:(1.1718-3.3690)]were independent predictive factors and included in the model.The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.CONCLUSION The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients.
文摘The psychosocial disorder of patients with enterostomy is still a huge challenge for the health systems.Acceptance and Commitment Therapy(ACT)has shown good results in permanent enterostomy in recent years.This paper explores the current status regarding ACT for patients with enterostomy in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.The study concludes that as a new psychological intervention method,ACT can significantly reduce the negative emotions and complications of patients with enterostomy,and improve their psychological flexibility,stoma acceptance,psychosocial adaptability,self-care ability and quality of life.
文摘AIM:To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant bowel.METHODS:We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO); the patients were divided into a delayed closure group (D group) and an early closure group (E group).RESULTS:The mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 ± 2.1 d) than in the D group (34.3 ± 5.9 d) (P < 0.0001). The duration of hospitalization after surgery was significantly shorter in the E group (33 ± 2.2 d) than in the D group (51 ± 8.9 d) (P < 0.0002).CONCLUSION:Endoscopic examination of blood flow and edema in the remnant bowel is useful to assess the feasibility of early closure of enterostomy in SMAO cases.
文摘Aim: Incarcerated stomal prolapse is a rare complication of enterostomy. Numerous procedures have been described, such as additional laparotomy to fix the intraabdominal intestine in place, enterostomy revision, or correction of the prolapse following stoma creation. The authors report successful managements by stomal reconstruction and discuss several clinical points, including the techniques of surgical revision for incarcerated stomal prolapse in loop enterostomy. Patients: Case 1) A female infant weighing 2755 g was delivered at 34 weeks of gestation. On the first day after birth, a right supra-abdominal transverse incision of 10 cm in diameter was used for transverse loop colostomy in a cloacal malformation. Two centimeters of the stomal loop was approximated with sutures to prevent evisceration of the small intestine between the 2 limbs of the loop. Interrupted sutures of 5-0 absorbable monofilament secured the seromuscle of the colon to the peritoneum and fascia, and also to the skin. The distal limb of the colostomy prolapsed 11 months after birth. The physical findings revealed that 10 cm of the distal limb was intussuscepted. Case 2) A female infant weighing 2550 g was delivered at 39 weeks of gestation. A radiological examination by contrast enema showed no spastic rectum and colon, as in Hirschsprung’s disease. Under the laparotomy of a right supra-abdominal transverse incision of 5 cm in diameter, loop ileostomy was performed at 30cm on the proximal side of the cecum such as Case 1. Subsequently, the proximal limb of the ileostomy prolapsed 2 days after operation. The physical findings revealed that 10 cm of the proximal limb was intussuscepted. New enterostomy formation: Divided enterostomy was performed with 3-cm stitching of each limb. The stomal site was moved to the inside from the previous stomal site to oversew and fix by the rectal fascia. The children have been well without trouble since undergoing the new eneterostomy formation. Conclusions: Operation to repair the prolapse of a stoma is advised if it causes problems. We found that simple mobilization of the bowel and excision of the redundant bowel provided a satisfactory result in the present cases.
文摘Objective:To discuss the research status of self-care agency assessment and intervention of enterostomy patients at home and abroad,and to provide reference for medical staff to understand the defects and needs of self-care agency of enterostomy patients and implement effective intervention.Methods:By searching the literature comprehensively,the latest research progress of self-care agency assessment and intervention of enterostomy patients at home and abroad was summarized.Results:The self-care agency assessment tools for patients with enterostomy included Stoma Self-Care Scale(SSCS),Specific Self-Care for Ostomized Patients Questionnaire(CAESPO)and Self-Care Competence of the Person with an Intestinal Stoma:Nursing School of Porto(CAO-EI:ESEP).Interventions included extended care,educational intervention and multidisciplinary team nursing.Conclusion:The concept of renewal should be used to evaluate the self-care agency of enterostomy patients from various aspects.In the future,we should actively carry out standardized research on the content and time of extended nursing and educational intervention,promote the extensive and standardized implementation of multidisciplinary team nursing,and promote the comprehensive improvement of self-care agency of enterostomy patients.
文摘Objective: To explore the clinical significance of “3H” nursing mode in improving negative emotions and insomnia in patients with enterostomy through a prospective cohort study. Methods: Adult patients who underwent enterostomy surgery in our gastroenterology department with negative emotions and insomnia between August 2021 and August 2022 were selected as research objects and randomly divided into “3H” nursing mode group and conventional nursing management group. For the conventional nursing group, routine standard nursing mode was adopted after enterostomy, while extra systematic “3H” nursing service on the basis of conventional nursing management was applied for its counterpart. SAS and SDS scores, Pittsburgh sleep quality index, Barthel index and nursing satisfaction were compared between the two groups. Results: SAS and SDS scores, Pittsburgh sleep quality index, Barthel index and nursing satisfaction of “3H” nursing mode group were evidently better than those of conventional nursing management group, and the difference was significant (P Conclusion: The “3H” nursing mode can effectively improve negative emotions of patients with enterostomy, such as anxiety and depression, improve their sleep quality and self-care ability in daily life, and play an important role in building a harmonious relationship between doctors and patients, nurses and patients, which is worthy of clinical application.
基金supported by National Natural Science Foundation of China(No.81603565)Tianjin University of Traditional Chinese Medicine Postgraduate Research Innovation Project(YJSKC-20201032).
文摘Aims:The study aimed to comprehensively search the systematic reviews and meta-analyses on quality of life in colorectal cancer patients with enterostomy in China and strictly evaluate the reporting quality,to promote the clinical transformation and implementation of evidence-based evidence on quality of life in colorectal cancer patients with enterostomy.Method:Cnki,Wanfang and VIP databases were comprehensively searched from the database construction to September 15,2021,to find the meta-analyses on quality of life in colorectal cancer patients with enterostomy in China.We used the PRISMA statement to evaluate their reporting quality rigorously.Results:9 articles were included in this study.Their PRISMA scores ranged from 18 to 24,with an average score of 20.44.The reporting rate of PRISMA in 9 articles was 70.37%to 88.89%.The 27 PRISMA items had a 0-100%reporting rate.Conclusion:The reporting quality of meta-analyses on quality of life in colorectal cancer patients with enterostomy in China is ideal.However,there are still 8 PRISMA items with a reporting rate of less than 70%,which need to be further improved in future research.
文摘Objective: To evaluate the effect of stoma comprehensive nursing in reducing postoperative complications of newborn enterostomy. Methods: from October 2018 to March 2020, 84 newborns undergoing enterostomy in our hospital were included in the study. All the subjects were randomly divided into control group (n = 42, routine nursing) and experimental group (n = 42, stoma comprehensive nursing). The postoperative complications and use time of ostomy bag of the two groups were compared. Results: compared with newborns in the control group, the total incidence of postoperative complications in the experimental group was lower, and the use time of ostomy bag was longer, with significant differences (P < 0.05). Conclusion: the application of stoma comprehensive nursing for newborn enterostomy has ideal effect, can prolong the use time of ostomy bag, and reduce the incidence of postoperative complications, which is worthy of wide application.
文摘Objective: to explore the application of family-centered nursing in children with enterostomy during perioperative period. Methods: 100 cases of patients with pediatric enterostomy in our hospital from August 2019 to August 2020 were collected and randomly divided into two groups. The control group received routine nursing, and the observation group received family-centered nursing. The length of stay and the incidence of enterostomy complications were compared between the two groups. Results: the hospitalization time of the observation group was shorter than that of the control group, and the incidence of enterostomy complications was lower than that of the control group, with significant difference (P < 0.05). Conclusion: the application effect of family-centered nursing in the period of enterostomy perioperative of children is accurate, which can reduce the complications of enterostomy, shorten the length of hospital stay. And it is the continuing nursing mode that is worthy of popularizing and applying.
文摘According to the causes of enterostomy fecal dermatitis, the corresponding nursing countermeasures were adopted. Through strengthening the prevention, identify the existing skin lesions and actively treat them, and comprehensively apply the cooperative care, evidence-based care and continuing care to the patients with enterostomy. It can effectively prevent the occurrence of enterostomy fecal dermatitis, accelerate the recovery of damaged skin, reduce the pain of patients, and improve living quality of patients. It has a significant clinical effect.
文摘The purpose of this article is to explain the important significance of telemedicine continuous care for patients after enterostomy. In the demonstration process, 176 patients who had undergone enterostomy were selected. During hospitalization, the patients were taught how to observe and care for stomostomy correctly, how to use dung bags correctly and how to soothe their anxiety under the professional demonstration of doctors and nurses, laying a good foundation for post-discharge nursing. After discharge, when patients encounter problems after ostomy, they can use information methods, such as wechat video, voice phone, wechat group, QQ group and other ways to seek help from doctors and experts for remote continuing care. After discharge, 134 of the 176 patients had discomfort with ostomy and postoperative complications. They chose convenient information methods to seek help. After the remote guidance of doctors, 98 patients handled ostomy problems at home according to the guidance of doctors, and their self-resolution rate reached 73.13%. Therefore, it is concluded that the remote continuing care in an information-based way can improve the ability of patients to solve postoperative problems by themselves.
基金Supported by Project of the Health Bureau of the Logistics and Security Department of the Central Military Commission,No.145BHQ090003076XMilitary Family Planning Special Fund,No.21JSZ18.
文摘BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.METHODS One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group.The control group(60 cases)received traditional telephone follow-up for continuity of care,while the study group(60 cases)used a visualization mobile terminal-based care model.The incidence of stoma-related complications,caregiver burden scale,and competence scores of children with stoma were compared between the two groups.RESULTS The primary caregiver burden score in the study group(37.22±3.17)was significantly lower than that in the control group(80.00±4.47),and the difference was statistically significant(P<0.05).Additionally,the caregiving ability score of the study group(172.08±3.49)was significantly higher than that of the control group(117.55±4.28;P<0.05).The total incidence of complications in the study group(11.7%,7/60)was significantly lower compared to the control group(33.3%,20/60;χ2=8.086,P=0.004).CONCLUSION The visual mobile terminal-based care model reduces caregiver burden,improves home care ability,lowers the incidence of complications and readmission rates,and supports successful second-stage reduction surgery for children with enterostomies.
文摘AIM To evaluate the occurrence and severity of enterostomy complications in newborns suffering from different intestinal disorders.METHODS A 10-year retrospective cohort study(2008-2017) investigated newborns that underwent enterostomy formation and reversal for different intestinal disorders. Only infants less than 28 d old at the time of enterostomy creation were included in the study(corrected age was applied in the cases of preterm neonates). The patients were divided into two groups according to their underlying diseases. Group 1 included infants suffering from necrotizing enterocolitis(NEC), whereas Group 2 included newborns diagnosed with intestinal disorders other than NEC, such as meconium obstruction, anorectal malformation, focal intestinal perforation, ileus, intestinal atresia and volvulus. The primary outcome measure was enterostomy-related morbidity. The data were analyzed statistically using Pearson's χ2 test or Fisher's exact test for categorical variables and the Wilcoxon-Mann-Whitney U-Test for continuous variables. RESULTS In total, 76 infants met the inclusion criteria and were evaluated for enterostomy-related complications. Neither group showed significant differences regarding gender, gestational age, weight at birth or weight at enterostomy formation. Infants suffering from NEC(Group 1) were significantly older at enterostomy for-mation than the neonates of Group 2 [median(range), 11(2-75) d vs 4(1-101) d, P = 0.004)]. Significantly more ileostomies were created in Group 1 [47(92.2%) vs 16(64.0%), P = 0.007], whereas colostomies were performed significantly more often in Group 2 [2(3.9%) vs 8(32.0%), P = 0.002]. The initiation of enteral nutrition after enterostomy was significantly later in Group 1 infants than in Group 2 infants [median(range), 5(3-13) vs 3(1-9), P < 0.001]. The overall rate of one or more complications in patients of both groups after enterostomy formation was 80.3%, with rates of 86.3% in Group 1 and 68.0% in Group 2(P = 0.073). Most patients suffered from two complications(23.7%). Four or more complications occurred in 21.6% of the infants in Group 1 and in 12.0% of the infants in Group 2(P = 0.365). Following enterostomy closure, at least one complication was observed in 26.0% of the patients(30.6% in Group 1 and 16.7% in Group 2, P = 0.321). The occurrence of complications was not significantly different between neonates with NEC and infants with other intestinal disorders. 48(65.8%) patients required no treatment or only pharmacological treatment for the complications that occurred [Clavien-Dindo-Classification(CDC) < Ⅲ], while 25(34.2%) required surgery to address the complications(CDC ≥Ⅲ). Early reversal of the enterostomy was performed significantly more often(P = 0.003) and the time to full enteral nutrition after closure was significantly longer [median(range), 7(3-87) d vs 12(5-93) d, P = 0.006] in infants with a CDC grading ≥Ⅲ than in infants with a CDC grading < Ⅲ. CONCLUSION Complications occur in almost all infants with enterostomies. The majority of these complications are minor and do not require surgical treatment. There is a clear trend that neonates with NEC have a higher risk for developing complications than those without NEC.
