Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1990

Colostomy as treatment for complications of spinal cord injury.

We reviewed our experience with colostomy performed in 20 spinal cord injury (SCI) patients to determine the effectiveness and safety of colostomy when it is performed for a late complication of SCI. Objective evaluation of gastrointestinal function, ie, colonic transit time and anorectal manometry, was performed in six patients with chronic gastrointestinal complaints to identify the site and severity of bowel dysfunction. Twelve patients had colostomy performed for chronic gastrointestinal problems, seven as an adjunct in the treatment of perineal pressure ulcers, and one for rectal cancer. When patients with difficult bowel evacuation or incontinence were considered, colostomy reliably simplified bowel care, relieved abdominal distention, and prevented fecal incontinence. The amount of time spent on bowel care decreased from an average of 98.6 min/day to 17.8 min/day (p less than .05) after colostomy. When performed as an adjunct in the treatment of pressure ulcers, colostomy provided a dry, clean environment, and seven of seven ulcers healed. Colostomy was well accepted by all patients; all patients with chronic gastrointestinal complaints reported that colostomy improved the quality of their lives. Objective testing differentiated between failure of the colon to adequately transport material to the rectum and inability to adequately evacuate the rectum. Testing was useful in choosing the level at which a colostomy was created, and, in one instance, it identified a specific syndrome (ischemic proctitis) which required colostomy.

Colostomy↗
PubMed1994

Factors influencing the safety of colostomy closure in the elderly.

Although colostomy closure is a commonly performed surgical procedure, there remains concern that the attendant risks may be misjudged, especially in the elderly. The purpose of this study was to evaluate the safety of performing colostomy closure and to define the factors that may influence morbidity and mortality in patients over the age of 70. Three hundred seven patients (178 males, 129 females) underwent colostomy closure over a 5-year period. The mean age was 52 years and 84 (27%) of the patients were 70 years or older. The indications for colostomy included diverticulitis, 115 (38%); malignancy, 47 (15%); perforation 35 (11%); trauma, 34 (11%); congenital anomalies, 26 (8%); obstruction, 13 (4%); bleeding, 6 (2%); colovesical fistulae, 6 (2%); polyps, 2 (0.7%); and miscellaneous, 23 (8%). An end colostomy was performed in 193 (63%) patients and a transverse loop colostomy in the remaining 114 (37%). There were no deaths. Complications occurred in 27 (9%) patients: 17 were directly related to colostomy closure (8 wound infections, 3 intraabdominal abscesses, 3 small bowel obstructions, 2 anastomotic strictures, and 1 anastomotic leak) while 10 were nonsurgical. Risk factors statistically associated with increased morbidity included age > 70 years (13% versus 5%), end versus loop colostomy (10% versus 2%), an operative time > 2 hr, and estimated blood loss > or = 500 ml (P < 0.05). ASA classification was only predicative of postoperative complications in patients over 70 years of age. We conclude that although colostomy closure can be performed without mortality, the increased morbidity associated with this procedure in patients 70 years or older necessitates careful preoperative assessment.

Adolescent↗
PubMed1994

Laparoscopic-assisted colostomy closure after Hartmann's procedure.

PURPOSE: The aim of the study was to review our experience with colostomy closure after Hartmann's procedure and the possible impact of laparoscopic colostomy closure. METHODS: A retrospective review of hospital stay after colostomy closure by laparotomy in the last four years was conducted. A chart review of patients undergoing laparoscopic colostomy closure after Hartmann's procedure since the introduction of operative laparoscopy at our institution was also done. RESULTS: One hundred twenty patients had colostomy closure carried out by the trauma service at the University of Miami/Jackson Memorial Hospital. In thirty-seven patients, colostomy closure was associated with other surgical procedures such as ventral herniorrhaphy, delayed closure of the open abdomen, ureteroneocytostomy, and so forth, or they underwent loop colostomy closure. These patients were excluded from further review. Sixty-five patients underwent reversal of Hartmann's procedure by laparotomy. They had an average hospital stay of 9.5 days (range, 6 to 34 days). This group of patients had colostomy closure prior to the introduction of operative laparoscopy in our institution. With increased laparoscopy experience, laparoscopically assisted Hartmann's reversal has been attempted in 18 patients and completed in 14 patients. The average hospital stay in the laparoscopically completed group was 6.3 days (range, 4 to 10 days). This group had a 0 percent mortality and a 14.3 percent morbidity. This compares favorably to recently reported series of colostomy closure by laparotomy. CONCLUSION: Laparoscopically assisted Hartmann's reversal results in comparable morbidity, but may be associated with shorter hospital stay when compared with laparotomy.

Adult↗
PubMed1988

The efficacy of loop colostomy for complete fecal diversion.

In an attempt to evaluate the real efficacy of loop colostomy for fecal diversion, the authors studied 62 patients previously colostomized under emergency conditions. Radiologic series of the abdomen were taken after 200 gm of barium meal. The results showed that the colostomy provided complete diversion of the radiologic contrast in 53 patients (85 percent) and incomplete diversion in nine patients (15 percent). Analysis of the results revealed that incomplete fecal diversion was: 1) observed as of the 86th postoperative day, with a significantly higher frequency following the 10th postoperative month, and 2) significantly correlated with either colostomy retraction or prolapse. The authors present a diagram showing a possible interaction of factors responsible for incomplete fecal diversion in loop colostomy and conclude that: 1) retraction is probably the basic contributing factor for colostomy failure; 2) the prolapse, once reduced, propitiates sinking of the stoma, facilitating colostomy failure; 3) the common assumption that loop colostomy eventually fails to provide complete fecal diversion is further supported; 4) loop colostomy assures, over its usual duration, a satisfactory defunctionalization of the colon; and 5) use of improved techniques of colostomy construction may prolong complete fecal diversion.

Abdominal Muscles↗
PubMed2006

The mechanical complications of colostomy in infants and children: analysis of 473 cases of a single center.

The purpose of this study was to determine the morbidity, mortality and possible risk factors in children who underwent colostomy. A total of 473 children who underwent colostomy in our clinic between 1983 and 2005 were retrospectively reviewed. Of these patients, 278 were boys and 195 were girls. The major indications for colostomy were anorectal malformation (252 patients), Hirschsprung's disease (117), and trauma (66). The patients' age ranged from 1 day to 15 years. Of the 473 patients, 254 (53.6%) were < 1 month of age, 97 (20.5%) were 1-12 months of age, and 122 (25.7%) were > 12 months of age. The side of colostomy was transverse in 341 (72%) patients and sigmoid in 132 (28%). The type of colostomy was loop in 364 (77%) patients and diverting in 109 (23%). Postoperative complication was observed in 80.5% of patients; excoriation (46.5%), prolapse (20.5%), stomal obstruction/stenosis (6.1%), and stomal bleeding (2.1%). A stomal revision was required for 26 (5.5%) patients. Overall, 50 (10.5%) patients died; 37 were related directly to major congenital anomalies, while 13 (2.7%) patients had a colostomy complication. The age of patients who died was < 1 month in 46 (92%) patients. The incidence of morbidity and mortality in children with colostomy is significantly high, particularly in neonates. Prompt colostomy procedure by an experienced hand, prompt stomal care under the supervision of a trained and experienced stomal care giver and early closure of the colostomy may increase the survival of these patients.

Adolescent↗
PubMed1984

Divided loop colostomy that does not prolapse.

A loop colostomy in infants and children is usually temporary, made through a small abdominal incision, and frequently prolapses its distal limb within months of its construction. Once this prolapse occurs, its permanent reduction is hardly ever achieved. On the other hand, the colostomy that is made at the time of a major laparotomy and the colostomy whose limbs are brought out through separate abdominal wall openings, rarely prolapse. The advantage of the loop colostomy over the latter two types is that it is easier to make and easier to close. Within the last 3 years, 13 infants and children received a form of loop colostomy that way easy to construct, easy to close, and did not prolapse between these two procedures. The loop colostomy (right transverse in all instances) was brought out through a small right upper quadrant transverse rectus cutting incision, and after the fascia was closed on either side of the colon loop, the latter was divided with the distal stoma tunnelled under the skin about 2.5 cm to the left and sutured to a second skin opening with interrupted 4-0 Dexon sutures. The proximal stoma was sutured to the original skin incision in a similar fashion. Function of this modified loop colostomy was no different, and neither the stomal therapist nor the parents had any trouble caring for this double type of colostomy opening. The closure was not any more difficult. Both stomas were mobilized through one longer than usual transverse incision, trimmed off, and the usual end-to-end colostomy anastomosis was made either extraperitoneal or intraperitoneal.

Adolescent↗
PubMed1991

Loop colostomies are totally diverting in adults.

Temporary colostomy is a mainstay in the treatment of patients with colon injuries. Common teaching is that loop colostomies are not totally diverting. We performed this study to determine whether loop colostomies are totally diverting. Twenty-three patients presenting for closure of loop colostomies were given barium by mouth. Serial abdominal films were obtained at intervals over 24 hours. Scout films were obtained after bowel preparation to see if flushing the colon could cause passage of barium into distal bowel. We could not demonstrate passage of barium into the distal limb of the colon in any patient studied. This was true even in long-established loop colostomies. Bowel preparation did not cause passage of barium into the distal colon. Loop colostomies constructed over a rod and matured immediately totally divert the fecal stream. Most surgeons would agree that this type of colostomy is more easily and quickly created and closed. Since it fulfills the criteria for fecal diversion, the use of divided colostomies should be abandoned when a loop colostomy can be utilized.

Adolescent↗
PubMed2006

Colostomy in anorectal malformations: a procedure with serious but preventable complications.

PURPOSE: Colostomy for patients with anorectal malformations decompresses an obstructed colon, avoids fecal contamination of the urinary tract, and protects a future perineal operation. The procedure is associated with several significant complications. MATERIALS AND METHODS: The medical records of 1700 cases of anorectal malformations were retrospectively reviewed. A total of 230 patients underwent reconstruction without a colostomy. Of the remaining 1470 patients, 1420 had their colostomy performed at another institution (group A) and 50 did at our institution (group B) using a specific technique with separated stomas in the descending colon. RESULTS: There were 616 complications identified in 464 patients of group A and in 4 patients in group B, an incidence of 33% vs 8% (P < .01). Complications in group A were classified into several groups. The first group was mislocation (282 cases), including 116 with stomas too close to each other, 97 with stomas located too distally in the rectosigmoid (which interfered with the pull-through), 30 with inverted stomas, 21 with stomas too far apart from each other, and 18 with right upper sigmoidostomies. The second largest group was prolapse (119 cases), which occurred mainly in mobile portions of the colon. The third group was composed of general surgical complications after colostomy closure (82 cases), such as intestinal obstruction (47 cases), wound infection (13 cases), incisional hernia (11 cases), anastomotic dehiscence (7 cases), sepsis (3 cases), and bleeding (1 case). Two of the septic patients died. Another group included 62 patients who received a Hartmann's procedure, which we considered to be contraindicated in anorectal malformations. A total of 42 patients suffered from stenosis of the stoma; 29, from retraction. CONCLUSIONS: Most colostomy complications are preventable using separated stomas in the descending colon. Mislocated stomas lead to problems with appliance application, interference with the pull-through, megasigmoid, distal fecal impaction, and urinary tract infections. Loop colostomies lead to urinary tract infections, distal fecal impaction, and prolapse. Prolapse is a potentially dangerous complication that mostly occurs when the stoma is placed in a mobile portion of the colon. Recognizing this makes the complication preventable by trying to create colostomies in fixed portions of the colon or by fixing the bowel to the abdominal wall when necessary. The trend to avoid colostomies is justified; however, colostomy is the best way to prevent complications in anorectal surgery and, when indicated, should be done with a meticulous technique following strict rules to avoid complications.

Abnormalities, Multiple↗
PubMed2006

Quality of life outcomes in 599 cancer and non-cancer patients with colostomies.

BACKGROUND: A colostomy is known to impact negatively on a patient's quality of life (QOL). Concerns include incontinence, rectal discharge, gas, difficulties in returning to work, decreased sexual activity, and travel and leisure challenges. Reports have described QOL outcomes in cancer patients with colostomies and inflammatory bowel syndrome with colostomies, but little has been written regarding a comparison of cancer and non-cancer populations. The purpose of this study was to describe QOL issues of colostomy patients and compare these issues in cancer and non-cancer participants. MATERIALS AND METHODS: A QOL-ostomy questionnaire was mailed to 2455 California members of the United Ostomy Association. RESULTS: Of the 1457 respondents (59%), 599 had a colostomy. Most were results from cancer (517/599), with colorectal cancer being the most common diagnosis. The most common benign diagnoses were inflammatory bowel disease and diverticulitis. Demographics were similar, except for more females in the non-cancer group (76%), and increased length of time with colostomy from the cancer group (mean 135.9 versus 106.4 months, P = 0.03). Common QOL problems included sexual problems, gas, constipation, travel difficulties, and dissatisfaction with appearance. Overall, cancer patients had less difficulty adjusting to their colostomies. CONCLUSIONS: Results confirmed the negative impact of a colostomy on QOL. While patients with cancer had a better overall QOL than those with benign processes, concerns were common to all colostomy patients. These results provide health care practitioners with information useful in discussing QOL concerns during pre-operation treatment decisions and post operative teaching and follow-up care.

Adaptation, Psychological↗
PubMed1995

Early closure of colostomies in trauma patients--a prospective randomized trial.

BACKGROUND: Most traumatic colon injuries can be repaired primarily, but a colostomy may still be required for severe colonic or rectal injury. The current trend is to reverse the colostomy early, rather than to wait the traditional 3 months before closure. METHODS: Forty-nine patients with colostomies after abdominal trauma were entered into the study. All patients had undergone a contrast enema in the second postoperative week to assess distal colon healing. Patients were excluded from early closure for nonhealing of the bowel injury, unresolving wound sepsis, or an unstable condition. We then compared the outcome of the remaining 38 (77.6%) patients allocated to either an early or a late colostomy group in a controlled, prospective, randomized trial. RESULTS: We found no significant difference in morbidity between the two groups, with an overall complication rate of 26.3%. Technically the early closure of colostomies was far easier than late closure and required significantly less operating time (p = 0.036) and with less intraoperative blood loss (p = 0.020). The closure of end colostomies was more time consuming, both early (p < 0.001) and late (p < 0.001) and caused more bleeding (p < 0.001 and p < 0.001, respectively). Total hospitalization was marginally shorter overall for early closure, but late closure of end colostomies resulted in prolonged hospitalization (p = 0.023). CONCLUSIONS: The early closure of colostomies and the use of loop colostomies whenever possible are recommended as both safe and beneficial for patients with colonic injury after trauma. Contraindications for early closure include nonhealing distal bowel, persistent wound sepsis, or persistent postoperative instability.

Adolescent↗
PubMed2005

A comparison of patient outcomes and quality of life in persons with neurogenic bowel: standard bowel care program vs colostomy.

BACKGROUND/OBJECTIVE: The purpose of this study was to compare patient outcomes and quality of life for people with neurogenic bowel using either a standard bowel care program or colostomy. METHODS: We analyzed survey data from a national sample, comparing outcomes between veterans with spinal cord injury (SCI) who perform bowel care programs vs individuals with colostomies. This study is part of a larger study to evaluate clinical practice guideline implementation in SCI. The sample included 1,503 veterans with SCI. The response rate was 58.4%. For comparison, we matched the respondents with colostomies to matched controls from the remainder of the survey cohort. A total of 74 veterans with SCI and colostomies were matched with 296 controls, using propensity scores. Seven items were designed to elicit information about the respondent's satisfaction with their bowel care program, whereas 7 other items were designed to measure bowel-related quality of life. RESULTS: No statistically significant differences in satisfaction or quality of life were found between the responses from veterans with colostomies and those with traditional bowel care programs. Both respondents with colostomies and those without colostomies indicated that they had received training for their bowel care program, that they experienced relatively few complications, such as falls as a result of their bowel care program, and that their quality of life related to bowel care was generally good. However, large numbers of respondents with colostomies (n = 39; 55.7%) and without colostomies (n = 113; 41.7%) reported that they were very unsatisfied with their bowel care program. CONCLUSION: Satisfaction with bowel care is a major problem for veterans with SCI.

Adult↗
PubMed1989

The influence of injury severity on complication rates after primary closure or colostomy for penetrating colon trauma.

The management of penetrating colon injury has been frequently debated in the literature, yet few reports have evaluated primary closure versus diverting colostomy in similarly injured patients. Diverting colostomy is the standard of care when mucosal penetration is present, but primary closure in civilian practice has generally had excellent results, although it has been restricted to less severely injured patients. Because the degree of injury may influence choice of treatment in modern practice, various indices of injury severity have been proposed for assessment of patients with penetrating colon trauma. As yet, however, there has been no cross-comparison of repair type versus injury severity. A retrospective study 76 patients who sustained penetrating colon trauma between January 1, 1979 and December 31, 1985 and who survived for at least 24 hours was conducted. Different preferences among attending surgeons and a more aggressive approach to the use of primary closure during the years of study led to an essentially random use of primary closure and diverting colostomy for moderate levels of colon injury, with mandatory colostomy reserved for the most serious injuries. Primary closure was performed in 37 patients (three having resection and anastomosis), and colostomy was performed in 39 patients. Severity of injury was evaluated by the Injury Severity Score (ISS), Penetrating Abdominal Trauma Index (PATI), and the Flint Colon Injury Score. Complications and outcome were evaluated as a function of severity of injury, and primary closure and colostomy were compared. Demographic profiles of the two groups did not differ regarding age, sex, mechanism of injury, shock, or delay between injury and operation. The mortality rate was 2.6% for each group. Major morbidity, including septic complications, occurred in 11% of the patients of the primary closure group and in 49% of those of the colostomy group. When PATI was less than 25, the Flint score was less than or equal to 2, or when the ISS was less than 25, primary closure resulted in fewer complications than did colostomy. Of the injury severity indices examined, the PATI most reliably predicted complications and specifically identified patients who whose outcome would be good with primary repair. These results suggest that the use of primary closure should be expanded in civilian penetrating colon trauma and that, even with moderate degrees of colon injury, primary closure provides an outcome equivalent to that provided by colostomy. In addition, the predictive value of the PATI suggests that it should be included along with other injury severity indices in trauma data bases.

Adult↗
PubMed2000

Diverting colostomy increases anastomotic leakage in the rat colon.

In the present study, we examined the effect of a diverting colostomy on the intestinal healing of colonic anastomosis in the rat. For this purpose, we created a colonic stenosis 2 days prior to the formation of a distal one-layer end-to-end anastomosis with or without a proximal double-barreled deviation colostomy in the rats. Radiological examination of anastomotic leakage was performed daily for 4 days and on day 7 after the operation. We found that anastomotic leakage was markedly increased in rats with a diverting colostomy compared to control animals; i.e. the leakage index (percentage of days with leakage during the experimental period) in colostomy rats was 29%, whereas in animals with no colostomy, the leakage index was only 7%. Interestingly, it was observed that anastomosis formation was associated with a higher mortality rate in rats with colostomy diversion (36%) compared to control animals (7%). However, there was no difference in suture holding capacity on day 7. Moreover, body weight decreased significantly in the colostomy group compared to rats without surgical defunctioning when followed for up to 7 days after surgery. Taken together, our novel findings suggest that a diverting colostomy may increase intestinal leakage after anastomosis formation in the rat colon. Thus, the role of proximal colostomy in the protection of colorectal anastomosis needs to be reevaluated and further investigations are required to resolve the influence of surgical defunctioning on intestinal healing.

Anastomosis, Surgical↗
PubMed2006

High risk of colostomy with primary radiotherapy for anal cancer.

BACKGROUND: Radiotherapy (RT) has become the primary treatment of choice for anal cancer in an effort to avoid colostomy. The current role of surgery appears generally to be underestimated, since diverting colostomy or abdominoperineal resection still often seems to be necessary for complications and local treatment failure after RT. METHODS: The data of 83 patients primarily treated by RT with curative intent throughout a 20-year period in our institute were analyzed regarding the need for colostomy. RESULTS: Totally, 28 patients (34%) required creation of a colostomy after primary RT for local failure or treatment-related complications during a mean follow-up period of 39 months. The 3-year actuarial colostomy-free rate was 59% (mean 85 +/- 9 months). Early stage disease, low T-score and absence of infiltration in adjacent organs were associated with a reduced need for colostomy in univariate analysis. In multivariate analysis only T-score was an independent variable in predicting prolonged colostomy-free interval. In this study, no statistically significant differences were noted for gender, age, nodal status, total radiation dose, radiation boost and concurrent chemotherapy. CONCLUSIONS: In approximately one-third of the patients treated by anal sphincter saving management with curative aimed primary RT, the creation of a colostomy appeared to be necessary for RT complications and local treatment failure. Therefore, patients should be well informed regarding the considerable risk of need for colostomy after RT for anal cancer.

Adult↗
PubMed1983

Review of colostomy in a community hospital.

This review of 193 colostomies was carried out to assess the procedure in our institution from standpoints of indications, technique, complications, and results. The study revealed colostomy was most commonly performed for obstruction, abdominoperineal resection, and infection or fistula associated with carcinoma, diverticulitis, and trauma in that order of frequency. The mortality rate was 2.6 per cent. Complications were observed in 22 per cent with 11 per cent being directly related to the colostomies themselves. Colostomy closure was accompanied by a 17 per cent complication rate and 1.5 per cent mortality. These overall results compare well with those of other investigators. Higher complication rates were found for colostomy for diverticulitis vs carcinoma; abscess or fistula vs obstruction or abdominoperineal resection; and for colostomy in the operative incision vs separate incision. The lowest rate was for colostomy for trauma. No significant difference in complication rate between transverse and sigmoid colostomies and colostomy closure by resection and anastomosis vs simple closure were noted.

Adolescent↗
PubMed1989

Primary repair vs. colostomy for the treatment of penetrating colon injuries.

The charts of 81 consecutive patients with penetrating colonic trauma were reviewed. Sixty-five patients were considered for evaluation. Penetrating abdominal trauma index, associated injuries, length of operative procedure, wounding agent, length of hospital stay, method of treatment, and septic complications were evaluated. Twenty-eight patients were treated with colostomy at the site of injury: five with diverting colostomy proximal to repair, 30 with primary repair (either single or multiple injuries), and two with exteriorization and early drop back. Overall septic morbidity was 15 of 65 (23 percent) patients. No statistically significant difference was found in morbidity between colostomy, 9 of 33 (27 percent), and primary repair, 6 of 30 (20 percent). The two patients with exteriorized repairs had no morbidity. No deaths were reported among the 65 patients studied. Thirty-two of the 33 (97 percent) colostomies were later closed with morbidity in 7 of 32 (22 percent). The mean length of stay for primary repair patients was 10.3 +/- 2.8 days and for colostomy patients, 25.7 +/- 3.8 days, counting days for both initial and colostomy closure admissions (P less than .05). Colostomy was not mandated by anatomic location or number of colonic injuries, circumference of colonic wall involved, presence of fecal contamination, or involvement of mesenteric blood supply. This study indicates that primary repair does not carry an increased risk of septic complications and saves the patient the significant risk and increased hospital stay of colostomy closure. Prospective studies addressing this area are indicated.

Adult↗
PubMed1985

Complications of colostomy closure.

A series of 126 colostomy closures was analyzed to evaluate factors contributing to morbidity. There were no deaths, but there was a 33 percent complication rate. Patients with penetrating abdominal trauma and foreign-body rectal perforations had fewer serious complications following colostomy closures than patients with diverticulitis or cancer. No significant difference was found in the anastomotic leak rate, length of surgery or length of hospitalization in patients with sutured or stapled anastomoses. Most patients in this series had end colostomies that required limited resection and anastomoses. Complication rates were comparable with previous series, which consisted predominantly of loop colostomy closures. The incidence of surgical complications was not related to the time interval between colostomy formation and closure. Timing of closure, however, significantly influenced the complication rate in two specific patient groups: patients with intraperitoneal colon perforation at the initial procedure when closure was performed within four weeks, and patients with surgical complications at the time of colostomy creation if they underwent closure within eight weeks. Early closures in patients still recovering from colostomy complications were associated with the highest incidence of anastomotic leak. Wound infections at stoma sites were decreased by leaving the skin open. The average hospitalization was 11.1 days for patients without complications, 15.5 days for those with wound infection, 18.5 days for patients with ileus, and 20.4 days for patients with anastomotic leaks. This study illustrates that the optimal time for colostomy closure must be determined on an individual basis. The morbidity can be minimized by delaying closure in specific groups of patients for one to two months. Delaying closure for an arbitrary time interval in all patients, however, is not warranted.

Adolescent↗
PubMed2002

Impact of stomatherapy on quality of life in patients with permanent colostomies or ileostomies.

BACKGROUND AND AIMS: The impact of a stoma on a patient's life is little discussed and is often underestimated, as well as the contribution of stomatherapy to health-related quality of life (QOL). This present study examined the problems faced by patients with ileostomies or colostomies and the possible contribution of stomatherapy to QOL. PATIENTS AND METHODS: Forty-three selected and well-documented stoma patients who had properly constructed, well functioning end colostomies or ileostomies were analyzed. Further analyses were carried out for the subgroups of patients with irrigating colostomies ( n=16), nonirrigating colostomies ( n=15), and ileostomies ( n=12). The digestive disease QOL questionnaire 15 (DDQ-15) was used to analyze QOL before and 3 months after stomatherapy. A second questionnaire consisting of 11 questions with yes/no answers was also used before and 3 months after stomatherapy to define more specifically the stoma-related problems of each patient as well as the frequency of each issue in a patient group at a given time. RESULTS: Cumulatively the mean QOL score was significantly higher after stomatherapy than before. Before stomatherapy the irrigating colostomy patients had the highest QOL score and the ileostomy group the lowest. QOL scores 3 months after stomatherapy were significantly higher in all groups than before. Again, the irrigating colostomy patients had a significantly higher score than the nonirrigating colostomy and ileostomy patients. Cumulatively all of the items improved significantly after stomatherapy, such as getting dressed, bathing, and participating in sports. CONCLUSION: These findings confirm that colostomy or ileostomy has a profoundly negative impact on QOL. Specialized counseling of these patients by a dedicated team improves QOL significantly.

Adult↗