Stoma-related complications and emergencies

Babakhanlou, Rodrick; Larkin, Kelly A.; Hita, A. Guido; Stroh, John; Yeung, Sai Ching Jim

doi:10.1186/s12245-022-00421-9

Cited by 32 publications

(29 citation statements)

References 39 publications

(119 reference statements)

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“…Liu et al 14 On the one hand, high-output stomas are often associated with extensive small bowel resections, in which less than 200 cm are preserved. 7,11,15 Therefore, patients presenting jejunostomies are at high risk of developing a high-output stoma due to an anatomical short bowel syndrome. On the other hand, patients without bowel shortness can also present high-output stomas caused by radiation or infectious enteritis, intra-abdominal sepsis, Crohn disease activity, sudden cessation of corticosteroids, or the use of prokinetic drugs.…”

Section: High-output Stomamentioning

confidence: 99%

“…This process can unquestionably be very irritative and toxic for the skin, and will perpetuate damage and morbidity. 7,16 Therefore, a valid method to avoid these complications may be attaching a spout measuring 2 cm to 3 cm to the ileostomy and avoiding any direct contact between the fluid and the skin. Furthermore, surgeons should aim to create a well-elevated stoma.…”

Section: Skinmentioning

confidence: 99%

“…Several etiologic factors have been associated with a higher incidence of stomal prolapse, such as obesity, pregnancy, conditions causing elevated abdominal pressure, chronic obstructive lung disease, and large surgical incisions. 7,38,39 Different grades of severity of a prolapse can be identified using a classification well described by Maeda, 39 which defines as grade 1 cases of reducible and asymptomatic prolapse; grade 2 refers to recurrent prolapse after manual reduction; Grade 3 is represented by more serious conditions that affect daily activities and present high-intensity symptoms, such as severe pain and unmanageable stoma; and grade 4 consists in life-threatening situations following a stoma prolapse. This classification can be helpful in terms of the choice of treatment.…”

Section: Stomal Prolapsementioning

confidence: 99%

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Ileostomy: Early and Late Complications

Santos,

Barbosa,

Teixeira

2024

Journal of Coloproctology

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Introduction Ileostomy formation is performed for multiple purposes related to intestinal pathology, such as obstructive malignant or benign tumors, inflammatory bowel diseases, intestinal ischemia, and, for the most part, as a protective stoma in high-risk anastomosis. The creation of this surgical opening, despite being considered a simple procedure, is undoubtedly followed by complications in certain cases. Materials and Methods We conducted an electronic literature search in the MEDLINE database using the PubMed search engine. A total of 43 articles were included in the present review. Results/Discussion Over the course of the present work, we were able to explore different types of complications that can arise in patients with an ileostomy. High-output stomas were found to be associated with dehydration and electrolyte imbalance. Skin-related morbidity was shown to be present in a great percentage of patients. More severe complications, such as peristomal pyoderma gangrenosum and necrosis, are less frequent and require urgent management. Several risk factors were identified in cases of retraction, obstruction, prolapse, and parastomal herniation. Conclusion Even though ileostomies may present numerous benefits in certain patients, they are also associated with many complications, which should be avoided and quickly managed, because they can severely affect the quality of life of the patients. Surveillance and follow-up by a multidisciplinary team is strongly advisable, bearing in mind that a good performance on the part of the responsible surgeon is also a key factor.

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Section: High-output Stomamentioning

confidence: 99%

Section: Skinmentioning

confidence: 99%

Section: Stomal Prolapsementioning

confidence: 99%

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Ileostomy: Early and Late Complications

Santos,

Barbosa,

Teixeira

2024

Journal of Coloproctology

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“…To examine whether the outlet is stenotic or obstructive, clinicians can simply insert their fingers into the stoma[ 23 ]. An abdominal CT scan or contrast enema study through the stoma may be useful for precise diagnosis, as they can demonstrate the location responsible for SOO/SRO and exclude other sites of SBO (Figures 1 and 2 ).…”

Section: Obstructive Complicationsmentioning

confidence: 99%

Obstructive and secretory complications of diverting ileostomy

Tsujinaka¹,

Suzuki²,

Miura³

et al. 2022

World J Gastroenterol

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This review aimed to highlight the etiology, diagnosis, treatment, and prevention of obstructive and secretory complications associated with diverting ileostomy (DI). Obstructive complications at the stoma site are termed stoma outlet obstruction (SOO) or stoma-related obstruction (SRO). The incidence of SOO/SRO is 5.4%-27.3%, and the risk factors are multifactorial; however, the configuration of the stoma limb and the thickness of the rectus abdominis muscle (RAM) may be of particular concern. Trans-stomal tube decompression is initially attempted with a success rate of 33%-86%. A thick RAM may carry the risk of recurrence. Surgical refinement, including a wider incision of the anterior sheath and adequate stoma limb length, avoids tension and immobility and may decrease SOO/SRO. Secretory complications of DI are termed high output stoma (HOS). Persistent HOS lead to water and sodium depletion, and secondary hyperaldosteronism, resulting in electrolyte imbalances, such as hypomagnesemia. The incidence of HOS is 14%-24%, with an output of 1000-2000 mL/d lasting up to three days. Treatment of HOS is commenced after excluding postoperative complications or enteritis and includes fluid intake restriction, antimotility and antisecretory drug therapies, and magnesium supplementation. Intensive monitoring and surveillance programs have been successful in decreasing readmissions for dehydration.

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“… 9–12 Moreover, proper functioning needs continued care for several physiological reasons including skin inflammation, electrolyte imbalances, stoma necrosis and parastomal hernias, and retraction or prolapse. 13 , 14 In a study interviewing 11 patients living with urostomy identified six themes that described their perception of the major concerns including 1) surgery impact, 2) body image, 3) daily and social-life activities, 4) stoma and sexuality, 5) managing stoma education, 6) family and friends’ support. 15 Hence, enhanced nursing care and nursing-patient interaction based on the scientific research is essential to assist these patients and achieve a better quality of life.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Nursing Care for Improving the Self-Efficacy & Health-Related Quality of Life in Patients with a Urostomy

Zhang

2023

JMDH

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Background Bladder cancer is the most predominant cancer of the lower urinary tract and is the most common cause for urostomy or urinary diversion. Urostomy immensely affect the patient’s everyday life from minor physical activity to social relations. Nurse-led interventions have been evaluated for improvement in quality of life in patients with urostomy. Objective The main objective of this study was to review the medical literature in a systematic way to evaluate the nursing role in improving the health-related quality of life of patients undergoing urostomy. Methods A systematic search of the PubMed, CINAHL, Embase, and Science Direct databases was carried out to identify studies that have evaluated the effect of nurse-led intervention on the self-efficacy and health-related quality of life in patients with urostomy. In addition, studies for factor affecting the quality of life were also investigated. Results Overall, 10 studies were identified as suitable for inclusion in this review. Health-related quality of life was lower in these patients as compared to population norms and several factors such as age, employment, and living status were identified as the contributing factors. Preoperative education was critical in meeting the psychological needs while postoperative intervention was instrumental in improving the self-efficacy and health-related quality of life particularly when a continued nursing-patient interaction was existent. Conclusion A comprehensive nurse-led intervention consisting of preoperative and postoperative components aimed at ostomy-related education, psychological counseling and compliant with patient factors is feasible and may result in greater improvement in self-efficacy and health-related quality of life in patients with urostomy. Larger clinical trials are warranted to validate these results.

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Stoma-related complications and emergencies

Cited by 32 publications

References 39 publications

Ileostomy: Early and Late Complications

Ileostomy: Early and Late Complications

Obstructive and secretory complications of diverting ileostomy

Enhanced Nursing Care for Improving the Self-Efficacy & Health-Related Quality of Life in Patients with a Urostomy

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