The development status of specialized nursing in ostomy care both in China and abroad

The status of ostomy-specialized nurses＇ training and the specialized care for patients with permanent colostomy both in China and abroad are analyzed. Based on features and characteristics of the development of ostomy care outside China, problems in China＇s ostomy care are discussed to promote the sustainable development of this type of care.

经皮的内视镜的 gastrostomy 的稀罕复杂并发症: 食道的癌的 Ostomy 转移

The authors present the case of a 55-year-old male with a stage Ⅲ(T4N1M0) squamous-cell esophageal carcinoma, who underwent percutaneous endoscopic gastrostomy(PEG). The pull method of tube placement was used. Five months after the procedure, the patient was referred to the hospital with a hard palpable tumour at the ostomy site. The hystologic exam revealed an abdominal wall metastasis of the esophageal cancer. The authors present this case because of the rarity of metastasis in ostomy after placement of PEG in patients with tumours located in the head and neck. In this particular context and judging by the rarity of situation, the clinical impact of this phenomenom is limited. Nevertheless, metastasis in ostomy site could be prevented by the push method, laparoscopy or laparotomy.

A review of the development and current status of wound ostomy continence nurses in the mainland of China

Wound ostomy continence nurses(WOC nurses),developed as an important part of clinical nurse specialists play an indispensable role in the management of ostomy,all kinds of chronic wounds and incontinent dermatitis.However,there exists a gap compared with developed countries and regions.This paper provides an overview of WOC nurses in China including origin and development,training and accreditation system,roles,values and management,in order to provide references for the development of WOC nurses in China.

An Analysis of the Application of the Suggestions of Clinical Practice Guideline for Ostomy Care in China:A Cross-Sectional Investigation

Background:Clinical practice guidelines refer to the guidance provided by the expert system to help medical staff and patients decide on appropriate treatments for a specific clinical situation,mainly including guidelines based on expert consensus and evidence-based guidelines.Since there is no research and clinical application of a specific stoma guidance in China.It is of great significance to understand the application status of the recommended guidelines and the influencing factors in promoting the development of stoma care.Purpose:To investigate the application status of recommended clinical practice guidelines for stoma nursing in China,and to analyse the reasons for the knowledge and application of recommendations.Methods:The Questionnaire on the Application of Recommendations in Clinical Practice Guidelines for Ostomy Nursing was adopted.Results:We collected 195 questionnaires and 183 valid questionnaires were available.(1)The average knowledge rate of a total of 31 recommendations was 73.65%.The main reasons for unknown were insufficient dissemination and lack of training.(2)The average application rate of the 31 recommendations was 58.08%.The overall satisfaction rate of people who used them was high.The main reasons for not applying recommendations were complex.Conclusions:Different levels of recommendations awareness and application are different.There is a lack of evidence-based guidelines for clinical practice in ostomy nursing in the field of stoma care in China,which limits the scientific development of stoma care to a certain extent.However,this study provides reference for the future construction of a guidebook adapted to our country’s localization.

Bibliometric analysis of literature regarding ostomy research based on the Web of Science database

Objective： To analyze the literature status and research hotspots of Science Citation Index （SCI）-related ostomy in the world and to provide references for scientific research and clinical work in the stoma care field. Methods： Based on the Web of Science core database and its own analysis function, HistCite analysis software and Excel were used to study the published research about ostomy patients. Results： A total of 1,262 articles were published between 1910 and 2016 with the authors from 48 countries and regions, 1,347 research institutions, published in 321 journals, with 4,048 first authors and coauthors; globally, there was a trend of slow growth in the number of authors every year. The study in the USA was absolutely in the lead position, and Canada and Turkey were more active. China＇s circulation volume was the 15th in the world. The periodical that published most often was the Journal of Wound Ostomy and Continence Nursing. The most interdisciplinary surgical studies were surgery and nursing, where these should be considered important. The most prolific author in the field was ＂Grant＂, and the highest cited article was entitled as ＂Living with a stoma： a review of the literature＂. Conclusions： The related research of global stoma is constantly developing. The research hotspot is nursing before and after stoma surgery. China and the USA are leading countries in research. They should follow the recent trend to improve the depth and breadth of the research in the field.

Utilized Theories by Nursing in the Care of People with an Ostomy: Integrative Review

Objective: To identify in the literature the theories used by nursing professionals in the care of people with an ostomy. Method: It’s about an integrative review of the literature used in the LILACS, BDENF, PubMed Central, CINAHL, Web of Science and SCOPUS database. Results: The sample was made of 18 publications. Most of them were studies published in the last five years (44.4%), international publications (72.2%), published in international periodicals (66.7%), with level IV of evidence (83.3%). It was identified in the articles that the nursing theories were shown as the most used by the nurses in the care of people with an ostomy (55.5%), followed by the theories borrowed from psychology (38.9%) and, finally, the theories borrowed from pedagogy (22.2%). Conclusion: The nurses are using the assistance nursing models with a higher frequency to subsidize their surveys, as well as borrowed theories, mostly being performed and published internationally and with a low evidence level, highlighting the need of studies with a higher stringent methodology and, beyond this, analysis research of the used theories.

Emotions of Gynecologic Cancer Patients Dealing with Permanent Colostomy:A Qualitative Interview Study

Purpose: This study was conducted to describe emotional state of colostomized patients with gynecologic cancer. Patients and Methods: The study employed a qualitative design from May to October of 2010, in a private university hospitals outpatient gnecologic oncology clinic in Ankara, Turkey. Content analysis with an inductive approach had been used to analyze 32 interviews that served as the data base for this study. Interview form that focused on what gynecologic cancer women felt to living with a colostomy. Results: Findings also reveal that gynecologic cancer patients with colostomy experience many uneasy feelings that affect their emotional state. The content analysis resulted in the development of two thematic units. The first we described as “To experience the consequences of stoma as a gynecologic cancer patients”. The second was “suffering experienced-being challenged the consequences of the stoma”, and the third was “promote self management-normalization of the new condition”. For the psychological support, family and friends’ support has been mentioned as the most important part that can release their anxiety. Conclusions: We concluded that a having stoma was difficult for the women. The emotional state of the women when they get colostomy was typically characterized by fear, and worry about their current process. Body image, self-esteem, social activity, sexuality were the aspects that most affected the patients. Nurses have very important role within holistic approach and empathetic interaction, for determining major problem areas.

Minor Omphalocele,Type IV Ileal Atresia,Congenital Ostomy

Abstract: Omphalocele is often associated with the presence of other congenital anomalies. Isolated minor omphaloceles are known to have a favorable prognosis. Case reports have demonstrated nonclassical associations occurring in minor omphaloceles. Intestinal atresia is seldom described as being associated with minor omphaloceles. Special attention should be paid to intestinal exploration in small omphaloceles to avoid complications. Here we report a new association of a minor omphalocele, type IV ileal atresia and congenital ostomy.

Reinforced tissue matrix to strengthen the abdominal wall following reversal of temporary ostomies or to treat incisional hernias

BACKGROUND Abdominal wall deficiencies or weakness are a common complication of tem-porary ostomies,and incisional hernias frequently develop after colostomy or ileostomy takedown.The use of synthetic meshes to reinforce the abdominal wall has reduced hernia occurrence.Biologic meshes have also been used to enhance healing,particularly in contaminated conditions.Reinforced tissue matrices(R-TMs),which include a biologic scaffold of native extracellular matrix and a syn-thetic component for added strength/durability,are designed to take advantage of aspects of both synthetic and biologic materials.To date,RTMs have not been reported to reinforce the abdominal wall following stoma reversal.METHODS Twenty-eight patients were selected with a parastomal and/or incisional hernia who had received a temporary ileostomy or colostomy for fecal diversion after rectal cancer treatment or trauma.Following hernia repair and proximal stoma closure,RTM(OviTex®1S permanent or OviTex®LPR)was placed to reinforce the abdominal wall using a laparoscopic,robotic,or open surgical approach.Post-operative follow-up was performed at 1 month and 1 year.Hernia recurrence was determined by physical examination and,when necessary,via computed tomo-graphy scan.Secondary endpoints included length of hospital stay,time to return to work,and hospital readmissions.Evaluated complications of the wound/repair site included presence of surgical site infection,seroma,hematoma,wound dehiscence,or fistula formation.RESULTS The observational study cohort included 16 male and 12 female patients with average age of 58.5 years±16.3 years and average body mass index of 26.2 kg/m^(2)±4.1 kg/m^(2).Patients presented with a parastomal hernia(75.0%),in-cisional hernia(14.3%),or combined parastomal/incisional hernia(10.7%).Using a laparoscopic(53.6%),robotic(35.7%),or open(10.7%)technique,RTMs(OviTex®LPR:82.1%,OviTex®1S:17.9%)were placed using sublay(82.1%)or intraperitoneal onlay(IPOM;17.9%)mesh positioning.At 1-month and 1-year follow-ups,there were no hernia recurrences(0%).Average hospital stays were 2.1 d±1.2 d and return to work occurred at 8.3 post-operative days±3.0 post-operative days.Three patients(10.7%)were readmitted before the 1-month follow up due to mesh infection and/or gastrointestinal issues.Fistula and mesh infection were observed in two patients each(7.1%),leading to partial mesh removal in one patient(3.6%).There were no complications between 1 month and 1 year(0%).CONCLUSION RTMs were used successfully to treat parastomal and incisional hernias at ileostomy reversal,with no hernia recurrences and favorable outcomes after 1-month and 1-year.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

A study of laparoscopic extraperitoneal sigmoid colostomy after abdomino-perineal resection for rectal cancer

Objective:To established a procedure for laparoscopic extraperitoneal ostomy after abdomino-perineal resection(APR)and study safety aspects and complications.Method:From July 2011 to July 2012,36 patients with low rectal cancer undergoing APR were included in the study and divided into extraperitoneal ostomy group(n=18)and intraperitoneal ostomy group(n=18).Short-and long-term complications were compared between the two groups.All patients were followed up and the median duration was 17 months(range:12-24).Results:The rates of short-term complication related to colostomies were comparable between the two groups,except the rate for stoma edema was higher in the extraperitoneal group(33.3%vs 0%;P=0.008).In the intraperitoneal ostomy group,two patients developed stoma prolapse,one had stoma stenosis,and two had parastomal hernia.In contrast,no long-term complications related to colostomies occurred in the extraperitoneal ostomy group.The rate of long-term complication was lower in the extraperitoneal ostomy group(0%vs 22.2%;P=0.036).Conclusion:The laparoscopic extraperitoneal ostomy is a relatively simple and safe procedure,with fewer long-term complications related to colostomy.However the follow-up period was not too long and needs to be extended.

Incidence of Ostomies in Tertiary Care Teaching Institution

A retrospective observational study was conducted at Saveetha medical college and hospital, over 2 years, from January 2017-January 2019. A total of 29 patients with ostomies were included in this study. Information regarding the types and indications of the ostomies were collected from the hospital records. The collected data were analyzed using Microsoft Excel, and represented by tables and charts. Majority of patients were the males and the predominant age group was 51 - 60 years old. The objective of the present study was to classify ostomies based on organs and to analyze the aetiology for creating those ostomies.