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At least 19 recordsLinked to original sources
PubMed1987

Enterostomy in necrotizing enterocolitis: an analysis of techniques and timing of closure.

Resection and enterostomy are the standard operative procedures for necrotizing enterocolitis (NEC). In order to compare the results of two different methods of enterostomy, a study was carried out in 100 infants with NEC who underwent enterostomy formation and closure. A single surgeon at each of the two collaborating institutions conducted the majority of operations. Level of enterostomy was jejunum in 10, ileum in 75, and colon in 15. Type of enterostomy was separate stomas (usually brought out side by side) in 50, Mikulicz enterostomy in 39, single stoma with Hartmann's pouch in 10, and loop colostomy in 1. Complications of enterostomy formation occurred in 24 infants (24%). When infants with separate stomas were compared with those with the Mikulicz enterostomy, there was no difference in the rate of stomal or wound complications. The separate stomas had a higher rate of stricture formation in the distal bowel (36% v 18%), which may be accounted for by earlier reestablishment of intestinal continuity in the Mikulicz group. Both methods exteriorized the bowel ends close to one another, which was advantageous because subsequent closure was usually performed without a formal laparotomy. After enterostomy closure, 17 (17%) infants had complications. There was no difference in complication rate between early (before 3 months or under 2.5 kg) v late closure, or between closure of the Mikulicz enterostomy v separate stomas (although the Mikulicz enterostomy closure was accomplished more rapidly than closure of separate stomas). Morbidity was unrelated to level of enterostomy, type of enterostomy, maturing the stoma, bringing it through a separate incision, or age or weight of the infant at closure.(ABSTRACT TRUNCATED AT 250 WORDS)

Colostomy↗
PubMed1988

Pre-surgery information and psychological adjustment to enterostomy.

The post-surgery psychological adjustment to enterostomy was examined in a longitudinal study of 120 patients. Subjects were representative of the general enterostomy patients population. All had undergone surgery in various hospitals located in Rome and its surroundings. Adjustment to enterostomy was longitudinally evaluated by interviewing patients at various intervals after enterostomy: soon after surgery; 1 year after surgery; more than 1 year after surgery. When patients were initially interviewed, information was requested on how they were informed of their clinical condition which led to surgery, as well as of enterostomy and its consequences. 42% reported a low level of understanding about enterostomy on the basis of information received during hospitalization. Patients were consequently divided into two groups, one including those judged as adequately informed (AI), and the other including those judged as not adequately informed (NAI). These groups were compared, for immediate adjustment to enterostomy (within 3-6 mos. since surgery), delayed adjustment (1 yr. since surgery), and prolonged adjustment (more than 1 yr. since surgery). Patients of NAI group demonstrated a consistently poorer pattern of adjustment in all parameters under study (emotional, cognitive, behavioral, social) and their adjustment to enterostomy did not show any spontaneous improvement over the time. AI patients, on the other hand, showed a more favorable level of adjustment since after surgery and a more positive pattern in the follow-up period. Adequate information before surgery and during hospitalization has been evidenced as a necessary component of patient care and a very important element in determining the optimal functional and psychological recovery of patients with enterostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1989

Prevention of hernia after enterostomy.

Enterostomies are usually well tolerated if they function optimally. A common problem is a hernia at the enterostomy site. Separation of the lateral aspect of the enterostomy tunnel from the seromuscular layer of the intestine permits a space to occur. With time, intra-abdominal pressure gradually enlarges this space to bring about the hernia. To prevent a hernia from developing after an enterostomy, a new principle of enterostomy construction is demonstrated. After proper positioning of the intestine within the tunnel, it is returned to the abdomen to allow accurate placement of sutures. These sutures bring together the lateral aspect of the tunnel and the remote side of the intestine. If no space is allowed, no hernia will occur.

Enterostomy↗
PubMed1990

[Temporary bitubular enterostomy. A convenient procedure].

In cases where double enterostomy is necessary, it is always possible to introduce a balloon catheter into the distal small bowel and to attach it to the deep surface of the abdominal wall, close to the proximal enterostomy. This "indirect" enterostomy facilitates fitting of the productive orifice, as well as resumption of digestion and, ultimately, restoration of the gastro-intestinal tract.

Catheterization↗
PubMedDate not supplied

Effect of enterostomy on quality of life in spinal cord injury patients.

To determine the difference in the bowel care of spinal cord injury patients before and after enterostomy, we interviewed 20 patients--19 men and one woman. Their ages were 27-75, median 55 years. The paralytic lesions were spastic in ten and flaccid in ten. A total of 24 enterostomies were done for the following reasons: fecal contamination of decubitus ulcer in seven, colonic tumor in six, perforation of the colon in four, prolapse of the large intestine in four, inconvenience of bowel care in two, and perirectal abscess in one. There were 17 sigmoid and five transverse colostomies, and two ileostomies. (Two patients accounted for six procedures.) Follow-up time ranged from three months to six years, median nine months. Bowel care time was reduced from 0.7-14 hours, median 6.0 hours per week preoperatively, to 0.3-7 hours, median 1.0 hours per week postoperatively. Reversal of fecal leakage, abdominal pain, gas and anorexia were also reported. All patients were happier with their bowel care after surgery. We conclude that enterostomy in the spinal cord injury patient makes bowel care considerably more convenient, and improves the quality of life as well.

Adult↗
PubMed1990

[A frequent complication of enterostomy: prolapse].

Among the other complications of enterostomy, prolapse deserves particular mention on account of the therapeutic problems involved in its correction. Based on a report of the authors' personal experience, the paper focuses on the mechanisms of onset and, above all, on the most appropriate forms of treatment, before continuing to describe the different surgical reparative techniques. In conclusion, the authors affirm that an optimal tailoring of the enterostomy and its appropriate preparation represent the ideal method of preventing the onset of prolapse.

Enterostomy↗
PubMed1990

[Enterostomy: preparation, construction and after care over time].

During the last decade the industry has developed material to improve the quality of life of patients with an enterostomy. Patients are better informed and prepared before operation. Postoperative advising by professional nurses help the patient to maintain an odorless, leak-proof and continent stoma. Most of the patients today with enterostomies are able to have a socially integrated life with minimal psychological and physical handicaps.

Adaptation, Psychological↗
PubMed1988

Enterostomy complications in infants.

A retrospective review of 48 infants, less than one year of age, with enterostomies was carried out to analyse the complications. Early complications were encountered in 3 patients (5%). Stoma complications occurred in 7 patients (14.6%) and revision was required in 2 cases. Total or near total parenteral nutrition was needed in 23 patients (48%). Of the 25 who tolerated oral feeding, 16 (64%) required extra sodium in their diet. Stoma-closure in 37 patients had a leakage rate of 8% and no mortality. Careful attention to technical details, diligent postoperative stoma care and early closure of the enterostomy if possible, seems to be the best way of avoiding complications.

Enterostomy↗
PubMed1975

The relationship of anaemia to gastric secretion more than 15 years after vagotomy and gastro-enterostomy.

Iron deficiency anaemia is common following vagotomy and gastro-enterostomy, and this study has shown that all the anaemic patients had low gastric secretion. After correction of their anaemia, gastric secretion was increased, but was still very low, and when these levels were compared with secretion in fit non-anaemic patients it was found that the latter group had a significantly higher secretion, and that a high proportion of them showed evidence of incomplete vagotomy. These results suggest that there is a relationship between the levels of gastric secretion in patients after vagotomy and gastro-enterostomy and the development pf anaemia. It may be that inadequate gastric secretion impairs the release of elemental iron from the diet and its subsequent absorption.

Anemia, Hypochromic↗
PubMed1979

Meconium ileus: laparotomy without resection, anastomosis, or enterostomy.

During the 14 yr from 1965 through 1978, 49 infants presented shortly after birth with intestinal obstruction due to impacted meconium. Three of these patients did not have fibrocystic disease. Eight patients were cured by a Gastrografin enema. There were 18 patients who had complications that included associated atresia, volvulus, and/or peritonitis. Various operations were done including resection with either primary anastomosis or enterostomy or varieties of the foregoing. Twenty-three babies had the simple uncomplicated form of meconium ileus. Eleven of these underwent resection and six patients died. Twelve patients were treated by laparotomy, ileotomy through a purse-string suture and prolonged irrigations using acetylcysteine. Of this group only one succumbed. This latter course of management is recommended for patients with simple uncomplicated meconium ileus as it involves no resection, no enterostomy, nor any primary anastomosis.

Cystic Fibrosis↗
PubMed1977

[2 variants of angular enterostomy].

To accelerate the self-healing of an intestinal fistula the author developed 2 variants of enterostomy based on the principle of valvular closure of the serous canal after the removal of the tube. The serous canal around the tube forms from the lateral walls of both bends of intestinal loop a fold in the shape of an angle. In the first variant the tube enters the intestinal lumen along the intestinal loop curvature line; in the second - through the lateral wall of one of the intestinal loop bends. The angular jejunostomy was applied as feeding fistula in 49 cases. The angular ileostomy was carried out on 24 cases to obtain the decompression of the small intestine. There were no cases of complications or fatal outcome resulting from the application of the angular enterostomy method.

Humans↗
PubMed1988

Enterostomy as an adjunct to treatment of intra-abdominal sepsis.

In 60 patients a small bowel enterostomy was constructed as part of the treatment of various intra-abdominal infectious and obstructive conditions. Eleven patients (18 per cent) died in the immediate postoperative period from continuing sepsis. In one patient closure of the stoma was not considered because of disseminated malignancy. In the remaining 48 patients continuity of the gut was subsequently restored. In 22 patients (46 per cent) complications occurred, 12 (25 per cent) of which were intra-abdominal septic complications. The occurrence of intra-abdominal complications was found to be linked to premature (i.e. within 3 months) closure of the stoma. Reasons for premature closure were stomal difficulties and prerenal azotaemia. Stomal closure was attended by a 10 per cent mortality rate.

Abscess↗
PubMed1992

Postobstructive enteropathy in infants with transient enterostomy: its consequences on the upper small intestinal functions.

Repeated or prolonged organic obstruction of the small intestine in the neonatal period can lead to severe refeeding problems, despite a transient ostomy. These problems are thought to result from a postobstructive enteropathy (POE) of the apparently normal small intestine segment above the obstruction. Ten infants with a POE, characterized by limited oral caloric and carbohydrate intakes and increased ostomy effluent, were compared with 8 controls with an enterostomy and a normal postoperative refeeding pattern. There was no statistical difference in the histomorphometric appearance of the mucosa or its digestive or absorptive capacity (brush-border hydrolases, glucose transport) between the two groups. The effluent and duodenal floras of the two groups were similar. However, all POE patients showed significant abnormal peristalsis characterized by barium and carmin transit times. This suggests that repeated or prolonged obstruction in the neonatal period could lead to a POE, caused by chronic motricity abnormalities of the small intestine above the obstruction. Although this POE is more frequent after small bowel atresia, it may also occur with other conditions causing prenatal and postnatal intestinal obstruction.

Enterostomy↗
PubMed1992

Transfer of an inferior rectus abdominis myocutaneous flap following enterostomy.

A rectus abdominis myocutaneous flap was successfully transferred in a patient in whom a mucous fistula had previously been brought through the midportion of the muscle. The flap was used to close a large defect in a paraplegic. Previous enterostomy is not a contraindication to the use of this flap. Preoperative arteriography to confirm the presence of a patent deep inferior epigastric artery is recommended prior to flap transfer.

Abdominal Muscles↗
PubMed1990

Percutaneous enterostomy with the Cope suture anchor.

Eighty-two percutaneous enterostomies were performed at three institutions with the Cope suture anchor for stomach or jejunal wall stabilization during alimentation tube placement. The anchors were successfully placed into the stomach or jejunum in 81 cases. Early in the series, two anchors were misplaced, with no sequelae. There were no other complications at the time of placement. In all successful cases, excellent immobilization of the viscus was achieved. Tract dilation and tube placement were easily performed, and there were no guidewire or tube dislodgments.

Adult↗
PubMedDate not supplied

[Psychological disorders in patients with enterostomy. The influence of age].

A retrospective study of patients who had undergone enterostomy and subsequent follow-up in the past 9 years was carried out with the aim of identifying differences with relation to symptoms of depression, the deterioration of social relations and sexual disturbances between elderly (age greater than or equal to 65) and non-elderly patients (age less than 65). Depressive symptoms were present to a greater extent in elderly (48.6%) than in non-elderly patients (34.8%), whereas sexual disturbances were experienced more in non-elderly (34.8%) than elderly (21.6%) patients. No striking differences were noted with regard to the deterioration of social relations. The differences observed, although marked in terms of percentage, were not statistically significant given the relatively small number of cases examined.

Age Factors↗
PubMed1991

[Disabling outcomes and psychological disorders in the patient with an enterostomy].

The authors carried out a retrospective study of patients undergoing enterostomy during the past 9 years. From 1981 to present a total of 60 patients (39 males and 21 females) were operated and subsequently followed-up. The aim of the study was to examine the following factors: the diagnosis which led to operation, the type of stoma used, early and late complications, the behaviour of the alvus, psychological disorders and Karnofsky's Performance-Status Index. After having presented the findings, the surgical results obtained are discussed together with the patient's psychological reactions to stoma. All types of early surgical complications were absent in 66.6% of patients, whereas late complications were absent in 41.6%. Even in those cases where surgical techniques and prostheses permitted a satisfactory post-operative outcome, the sociopsychological and sexual problems relating to the wound and the perceived difference between the real and ideal Ego are highlighted.

Adult↗