Resultados de cirugía resectiva colorrectal por Endometriosis Infiltrante Profunda: 6 años de experiencia

Objetivo: Describir los resultados tempranos de la cirugía resectiva colorrectal por Endometriosis Infiltrante Profunda (EIP) en mujeres intervenidas en centro clínico privado, durante los últimos 6 años. Material y Método Estudio transversal que muestra la evolución clínica de pacientes intervenidas quirúrgicamente con resecciones colorrectales por diagnóstico de (EIP), entre los años 2016-2022 en Clínica Indisa. Se agruparon en resecciones discoidales (Grupo I) y segmentarias (Grupo II) Resultados: De los pacientes operados por (EIP) entre los años 2016 al 2022, 160 pacientes fueron sometidas a resecciones colorrectales, 56 en el Grupo I y 104 en el grupo II. Las características demográficas de ambos grupos fueron similares, con excepción del hábito tabáquico que mostró un predominio en el Grupo II. El análisis de las variables quirúrgicas (tipo de abordaje, tasa de conversión, altura de la anastomosis y ostomía de protección) mostró una distribución similar en ambos grupos. En relación a la evolución postoperatoria, el Grupo I presentó una disminución significativa en el tiempo de realimentación con sólidos de 2 vs 3 días (p = 0,001). El inicio del tránsito intestinal, días de hospitalización y presencia de complicaciones Clavien-Dindo > = 3, no presentó diferencias significativas entre ambos grupos. Discusión: La endometriosis afecta, significativamente, a mujeres en todo el mundo, existiendo escasa evidencia que reporte los resultados de las cirugías colorrectales que comparen ambas técnicas, demostrando que el manejo en centros especializados tiene mejores resultados. Conclusión: Al comparar estas dos técnicas de resección colorrectal en DIE, concluimos que los pacientes operados por resección discoidal tienen una realimentación más temprana sin diferencias significativas en el resto de las variables estudiadas.

Objective: To describe the early outcomes of resective colorectal surgery for Deep Infiltrating Endometriosis (DIE) in women treated at private center over the past 6 years. Materials and Methods: This cross-sectional study presents the clinical evolution of surgically treated patients with colorectal resections for DIE diagnosis between 2016 and 2022 at Clínica INDISA. They were grouped into discoid resections (Group I) and segmental resections (Group II). Results: Of patients operated for DIE between 2016 and 2022, 160 underwent colorectal resections, with 56 in Group I and 104 in Group II. The demographic characteristics of both groups were similar, except for smoking habits, which showed a predominance in Group II. The analysis of surgical variables (approach type, conversion rate, anastomotic height, and protective ostomy) showed a similar distribution in both groups. Regarding postoperative outcomes, Group I showed a significant decrease in solid food resumption time, 2 vs 3 days (p = 0.001). The initiation of intestinal transit, hospitalization days, and presence of Clavien-Dindo complications >= 3 did not present significant differences between both groups. Discussion: Endometriosis significantly affects women worldwide, with limited evidence reporting colorectal surgery outcomes comparing both techniques, demonstrating that management in specialized centers yields better results. Conclusion: When comparing these two techniques of colorectal resection in DIE, we conclude that patients undergoing discoid resection have an earlier resumption of solid food intake without significant differences in the remaining studied variables.

Usefulness of Preoperative Anorectal Manometry for Ostomy Closure: A Cross-sectional Study / Utilidad de la manometría anorrectal prequirúrgica para el cierre de ostomías: un estudio de corte transversal

Abstract Introduction: For several reasons, a patient may be taken to a colostomy for closure as soon as possible. However, their treatment may vary, and predicting adequate continence after colostomy closure can be difficult. The objective is to characterize preoperative manometry because, in Colombia, few cases describe its usefulness. Methods: A descriptive cross-sectional study of adult patients treated in two gastroenterology centers in Colombia between 2018 and 2020. Results: Of 316 patients, 13 were indicated manometry before colostomy closure, predominantly women (69%), with an average age of 51.69 years (standard deviation: 24.18). When evaluating the basal pressures of the anal sphincter, we noted 68% hypotonia, 16% hypertonia, and 16% normal pressures. The voluntary contraction test was abnormal in 25%, and a pattern of dyssynergic defecation was observed in 30%, all with type III patterns. The inhibitory rectoanal reflex was present in 92%, with an abnormal balloon expulsion test in 100% of patients. More than 70% of patients persisted with the colostomy in situ after the first year of construction and 30% beyond 36 months. Conclusions: The present study posits questions about the cost-effectiveness of anorectal manometry before colostomy closure, which requires corroboration by studies with more patients and more robust methodological designs.

Resumen Introducción: Hay varias razones por las que un paciente puede ser llevado a una colostomía con el objetivo de cerrarla lo antes posible, pero su tratamiento puede variar, y predecir una adecuada continencia posterior al cierre de la colostomía puede ser difícil. Se plantea como objetivo realizar una caracterización de la manometría prequirúrgica debido a que en Colombia hay pocos casos que describan su utilidad. Metodología: Estudio observacional descriptivo de corte transversal en pacientes adultos atendidos en dos centros de gastroenterología en Colombia entre el 2018 y el 2020. Resultados: De 316 pacientes, 13 tenían indicación de manometría previo a cierre de colostomía, predominantemente mujeres (69%), con una edad promedio de 51,69 años (desviación estándar: 24,18). Al evaluar las presiones basales del esfínter anal, se evidenció 68% de hipotonía, 16% de hipertonía y 16% de presiones normales. La prueba de contracción voluntaria fue anormal en el 25%, se observó un patrón de disinergia defecatoria en el 30%, todas con patrón tipo III. El reflejo rectoanal inhibitorio estuvo presente en el 92%, con prueba de expulsión de balón anormal en el 100% de los pacientes. Más del 70% de los pacientes persistían con la colostomía in situ después del primer año de su construcción y 30% más allá de 36 meses. Conclusiones: El presente estudio genera cuestionamientos acerca la costo-efectividad de la manometría anorrectal previa al cierre de colostomía, lo cual requiere ser corroborado por estudios con una mayor cantidad de pacientes y diseños metodológicos más robustos.

Congenital Neonatal Colonic Atresias Arising in Watershed Areas of the Colonic Blood Supply

There are certain junctional weak points in the colonic marginal artery blood supply, known as watershed areas, which result from congenital incomplete development of anastomoses of the marginal arteries. These critical points in the marginal arcade are more vulnerable to consequences of ischemic injury than other parts of the marginal arterial arcade. We report herein the series of five patients who developed colonic atresia well localized in the rectosigmoid region at Sudeck抯 point in two patients, in the splenic flexure region at Griffith抯 point in one patient and in the cecum-ascending colon junction in one patient respectively and a very interesting case of wide spread multiple junctions at middle colic and inferior mesenteric artery distribution type 3 atresia in one case. This report and our review of the literature suggest that watershed areas, including Sudeck抯 point or rectosigmoid junction area, the splenic flexure or Griffith抯 point and the ileocecal region between ileal and colic branches and combinations thereof, are high-risk regions for the development of colonic atresia and rarely the vascular insult can be major and can involve key branch of marginal arcade leading to short colon syndrome. We have treated all different approaches with one stage, two stage and three stage open, laparoscopic and minimal invasive periumbilical approach. All three approaches and single stage or staged approaches are safe and effective in colonic atresias depending on the case and available resources. An attempt to save ileocecal valve, appendix and cecum with ceco-coloplasty in the initial stage did not work and had to finally perform subtotal resection of the dilated cecum and part of the ascending colon with preservation of the ileocecal valve and the appendix at corrective surgery in the right colonic atresia case. We had motility disorders associated with two of our cases.

Estomas: complicaciones, manejo y prevención. Una revisión actual / Stomas: complications, management, and prevention. An updated review

Introducción. La resección segmentaria del intestino y su derivación temporal o definitiva es un procedimiento frecuente en la práctica quirúrgica, que implica la construcción de un estoma. La enfermedad que lleva a la cirugía, las condiciones clínicas del paciente y los aspectos técnicos en la construcción de la ostomía son puntos claves en la evolución posoperatoria. Métodos. Se realizó una revisión de la literatura identificando las complicaciones asociadas a la construcción de estomas, con el objetivo de ofrecer herramientas de tratamiento y toma de decisiones al personal médico involucrado en la atención de estos pacientes. Resultados. La cirugía de urgencia, la inmunosupresión, la obesidad y la técnica en la apertura del orificio en la pared abdominal, favorecen la aparición de complicaciones tempranas que requieren manejo médico o reintervención quirúrgica. Conclusiones. Todo paciente con estoma debe ser valorado minuciosamente por el cirujano y la terapista enterostomal en las primeras 72 horas luego de la cirugía.

Introduction. Segmental resection of the intestine and its temporary or permanent bypass is a frequent procedure in surgical practice, which involves the construction of a stoma. The disease that leads to surgery, the clinical conditions of the patient and the technical aspects in the construction of the ostomy are key points in the postoperative evolution. Methods. A review of the literature was performed, identifying the complications associated with the construction of stomas, with the aim of offering treatment and decision-making tools to the medical personnel involved in the care of these patients. Results. Emergency surgery, immunosuppression, obesity, and the technique used to open the orifice in the abdominal wall favor the appearance of early complications that require medical management or surgical reintervention. Conclusions. Every patient with a stoma must be carefully evaluated by the surgeon and the enterostomal therapist in the first 72 hours after surgery.

A health mobile application for self-care of colostomy patients

Introduction and Objective: In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life. Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients. Materials and Methods: In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided. Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the "acceptable" level, with a rate of 85%. Discussion and Conclusion Based on the findings of the current research, thesoftware developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them. (AU)

Quality of life and financial impacts of permanent colostomy for rectal cancer

Introduction: Returning to work is an important cancer recovery milestone. Permanent colostomy can be required for rectal cancer treatment and can significantly impact well-being. We aimed to evaluate the impact of permanent colostomy on health-related quality of life and return to work in patients with rectal cancer. Methods: This was a retrospective cohort study on 23 employed patients receiving curative surgery for rectal cancer requiring permanent colostomy. Demographic and health-related quality-of-life questionnaires (the Colostomy Impact Score (CIS), the EORTC Quality of Life Questionnaire (QLQ)-C30, and the EORTC QLQ-CR29) were posted to eligible patients. Results: On average, patients (10 female, 13 male, mean age 61.8 years) were 5.0 ± 3.5 years post-surgery. At the time of questioning, 73.9% had returned to work (21.7% changed their type of work), while 17.4% never returned to work. Of those that returned to work, 11.8% returned within 1 month of surgery, while 23.5% had not returned after 12 months. Comparison of CIS between patients that returned to the same work (14.6 ± 0.93), changed their work (13.0 ± 0.74), and did not return to work (14.3 ± 2.3) revealed no significant differences (p = 0.36). CIS did not correlate with days worked on return, or time to return to work (p > 0.05). Conclusion: Returning to work following rectal cancer treatment with permanent colostomy is challenging, with 17.4% never returning to work. Of those who returned to work, 23.5% required more than 12 months. This was not associated with CIS in our study. (AU)

Effect of structured in-service training on nurses' knowledge, practice, and self-confidence regarding patients' colostomy care / Efecto de la capacitación estructurada en servicio sobre el conocimiento, práctica y autoconfianza de los enfermeros respecto al cuidado de pacientes con colostomía / Efeito do treinamento estruturado em serviço no conhecimento, prática e autoconfiança dos enfermeiros em relação ao cuidado de pacientes com colostomia

ABSTRACT Objective: To determine the impact of structured in-service training on nurses' knowledge, practice, and self-confidence regarding caring for patients with colostomy. Method: Utilizing a one-group pretest-posttest quasi-experimental study design, the study was conducted in the oncology department at Egypt Health Care Authority hospitals in Port Said governorate (Elmabra Hospital) and the oncology institute in Damietta City. From October 2023 to January 2024, 50 nurses from the oncology departments of the two cities in Egypt participated in the study to assess their knowledge, practice, and self-confidence before and after exposure to in-service training about colostomy care. Data analysis was carried out using descriptive, correlational, and inferential statistics. Results: Implementation of Structured In-service Training significantly improved nurses' total knowledge scores, practice scores, and self-confidence levels (p ≤ 0.05). Notably, a more robust positive correlation emerged after training between nurses' knowledge and practice, knowledge and self-confidence, and practice and self-confidence (r=0.757, r=0.738, and r=0.619, respectively). However, the correlations were significant before the training program as well. Conclusion: The study underscores a critical necessity for nurses to concentrate on the specialized field of colostomy care by establishing a routine in-service training system. Further research is warranted to validate the findings of this investigation.

RESUMEN Objetivo: Determinar el impacto de la capacitación estructurada en servicio sobre el conocimiento, práctica y autoconfianza de los enfermeros respecto al cuidado de pacientes con colostomía. Método: Utilizando un diseño cuasi-experimental de un solo grupo con pretest y postest, el estudio se realizó en el departamento de oncología de los Egypt Health Care Authority hospitals, Port Said governorate (Elmabra Hospital) y en el Instituto de Oncología en la ciudad de Damietta. Entre octubre de 2023 y enero de 2024, 50 enfermeros de los departamentos de oncología de las dos ciudades de Egipto participaron en el estudio para evaluar su conocimiento, práctica y autoconfianza antes y después de recibir capacitación en servicio sobre el cuidado de la colostomía. El análisis de datos se realizó utilizando estadísticas descriptivas, correlacionales e inferenciales. Resultados: La implementación de la capacitación estructurada en servicio mejoró significativamente los puntajes totales de conocimiento, práctica y niveles de autoconfianza de los enfermeros (p ≤ 0.05). Cabe destacar que después de la capacitación surgió una correlación positiva más fuerte entre el conocimiento y la práctica, el conocimiento y la autoconfianza, y la práctica y la autoconfianza de los enfermeros (r=0.757, r=0.738 y r=0.619, respectivamente). Sin embargo, estas correlaciones también fueron significativas antes del programa de capacitación. Conclusión: El estudio destaca la necesidad crítica de que los enfermeros se concentren en el campo especializado del cuidado de la colostomía mediante el establecimiento de un sistema de capacitación en servicio de rutina. Se requiere más investigación para validar los hallazgos de esta investigación.

RESUMO Objetivo: Determinar o impacto do treinamento estruturado em serviço no conhecimento, prática e autoconfiança dos enfermeiros em relação ao cuidado de pacientes com colostomia. Método: pesquisa quase-experimental de um único grupo com pré-teste e pós-teste, o estudo foi conduzido no departamento de oncologia do Egypt Health Care Authority hospitals em Port Said governorate (Elmabra Hospital) e no instituto de oncologia na cidade de Damietta. De outubro de 2023 a janeiro de 2024, 50 enfermeiros dos departamentos de oncologia das duas cidades participaram do estudo para avaliar seu conhecimento, prática e autoconfiança antes e depois do treinamento em serviço sobre cuidado de colostomia. A análise dos dados foi realizada utilizando estatísticas descritivas, correlacionais e inferenciais. Resultados: A implementação do Treinamento Estruturado em Serviço melhorou significativamente os escores totais de conhecimento, prática e níveis de autoconfiança dos enfermeiros (p ≤ 0,05). Notavelmente, após o treinamento, surgiu uma correlação positiva mais robusta entre o conhecimento e a prática, o conhecimento e a autoconfiança, e a prática e a autoconfiança dos enfermeiros (r=0,757, r=0,738 e r=0,619, respectivamente). No entanto, essas correlações também foram significativas antes do programa de treinamento. Conclusão: O estudo destaca a necessidade crítica de que os enfermeiros se concentrem no campo especializado do cuidado de colostomia, estabelecendo um sistema de treinamento em serviço de rotina. São necessárias mais pesquisas para validar os achados desta investigação.

Sociodemographic and clinical characterization of patients undergoing intestinal transit reconstruction: a cross-sectional study / Caracterización sociodemográfica y clínica de pacientes sometidos a reconstrucción de tránsito intestinal: estudio transversal / Caracterização sociodemográfica e clínica de pacientes submetidos à reconstrução de trânsito intestinal: um estudo transversal

ABSTRACT Objective: to analyze the sociodemographic and clinical data of patients with temporary stomas who underwent intestinal transit reconstruction. Method: this is a cross-sectional study based on the medical records of all patients at a tertiary hospital in Teresina-Piauí, between September/2021 and June/2023. The data was tabulated in Microsoft Excel and analyzed in IBM SPSS (version 20.0), using absolute (n) and relative (%) frequencies, mean, standard deviation, Shapiro-Wilk test, Mann-Whitney U test, chi-square test and Spearman's correlation. The significance level adopted was 5%. Results: among the 90 patients analyzed, the majority were men (71.1%), black (84.4%), single (54.4%) and without a high school education (54.4%). The mean age was 45.7 years. The most prevalent stomas were loop colostomies (27.8%) and Hartmann stomas (24.4%), most of which were in the lower right (48.9%) and lower left (44.4%) quadrants of the abdomen and were caused by appendicitis (17.8%), firearm perforation (14.4%) and colorectal cancer (12.2%). The majority had no comorbidities (58.9%) and no post-operative complications (74.4%). Among the 23 (25.6%) with complications, seven (7.8%) had their surgery redone and eight (8.9%) required intensive care, with two (2.2%) deaths. Post-surgical complications were associated with a longer post-operative stay (p<0.001). Conclusion: there was a predominance of black men, with no high school education and a mean age of 45.7 years old. The most frequent stomas were of the loop colostomy and Hartmann's type. Appendicitis, colorectal cancer and firearm perforation were the main reasons. Post-surgical complications were significantly associated with a longer post-operative stay.

RESUMEN Objetivo: analizar datos sociodemográficos y clínicos de pacientes con ostomías temporales sometidos a reonstrucción del tránsito intestinal. Método: estudio transversal, basado en las historias clínicas de todos los pacientes de un hospital de tercer nivel, en Teresina-Piauí, entre septiembre de 2021 y junio de 2023. Los datos fueron tabulados en Microsoft Excel y analizados en el programa IBM SPSS (versión 20.0), utilizando frecuencias absolutas (n) y relativas (%), media, desviación estándar, prueba de Shapiro-Wilk, prueba U de Mann-Whitney, chi-cuadrado y Correlación de Spearman. El nivel de significancia adoptado fue del 5%. Resultados: entre los 90 pacientes analizados predominaron los hombres (71,1%), negros (84,4%), solteros (54,4%) y sin educación secundaria completa (54,4%). La edad promedio fue de 45,7 años. Las ostomías más prevalentes fueron colostomía en asa (27,8%) y Hartmann (24,4%), que se realizaron principalmente en los cuadrantes inferior derecho (48,9%) e inferior izquierdo (44,4%) del abdomen y los motivos fueron apendicitis (17,8%), herida de bala (14,4%) y cáncer colorrectal (12,2%). La mayoría no presentó comorbilidades (58,9%) ni complicaciones postoperatorias (74,4%). Entre los 23 (25,6%) que tuvieron complicaciones, siete (7,8%) tuvieron cirugía reconstruida y ocho (8,9%) requirieron cuidados intensivos, con dos (2,2%) muertes. Las complicaciones posquirúrgicas se asociaron con estancias postoperatorias más prolongadas (p<0,001). Conclusión: predominaron los hombres de raza negra, sin educación secundaria completa y con una edad promedio de 45,7 años. Las ostomías más frecuentes fueron la colostomía en asa y tipo Hartmann. Los principales motivos fueron apendicitis, cáncer colorrectal y heridas de bala. Las complicaciones posquirúrgicas se asociaron significativamente con estancias posoperatorias más prolongadas.

RESUMO Objetivo: analisar dados sociodemográficos e clínicos de pacientes com estomias temporárias, submetidos à reconstrução de trânsito intestinal. Método: trata-se de um estudo transversal a partir dos prontuários de todos os pacientes de um hospital terciário, em Teresina-Piauí, entre setembro de 2021 e junho de 2023. Os dados foram tabulados no Microsoft Excel e analisados no programa IBM SPSS (versão 20.0), utilizando frequências absolutas (n) e relativas (%), média, desvio padrão, teste Shapiro-Wilk, teste U de Mann-Whitney, teste qui-quadrado e correlação de Spearman. O nível de significância adotado foi de 5%. Resultados: dentre os 90 pacientes analisados, predominaram homens (71,1%), negros (84,4%), solteiros (54,4%) e sem ensino médio completo (54,4%). A média de idade foi de 45,7 anos. As estomias mais prevalentes foram colostomia em alça (27,8%) e Hartmann (24,4%), que, majoritariamente, estavam nos quadrantes direito inferior (48,9%) e esquerdo inferior (44,4%) do abdômen e tinham como motivações apendicite (17,8%), perfuração por arma de fogo (14,4%) e câncer colorretal (12,2%). A maioria não tinha comorbidades (58,9%) e não apresentou complicações pós-operatórias (74,4%). Dentre os 23 (25,6%) com complicações, sete (7,8%) tiveram cirurgia reconfeccionada e oito (8,9%) necessitaram de terapia intensiva, havendo dois (2,2%) óbitos. Complicações pós-cirúrgicas associaram-se a maior tempo de permanência no pós-operatório (p<0,001). Conclusão: predominaram homens negros, sem ensino médio completo e com média de idade de 45,7 anos. As estomias mais frequentes foram do tipo colostomia em alça e Hartmann. Apendicite, câncer colorretal e perfuração por arma de fogo foram as principais motivações. Complicações pós-cirúrgicas associaram-se significativamente à maior permanência no pós-operatório.

Emergency intestinal stomas incidence and early complications

Background: An intestinal stoma is a frequently performed procedure with a high percentage of complications. Even though creating an intestinal stoma is a procedure that can save lives while treating various gastrointestinal conditions, its accompanying morbidity and mortality have been the topic of many studies. This study was carried out in order to better understand a variety of complications in various types of intestinal stomas. Methods: A total of 60 patients with intestinal stoma construction in the general surgery emergency department at Kasr Al-Ainy emergency hospital Cairo, Egypt as an emergency procedure from December 2019 to May 2020 were included in this prospective cohort analysis. The inclusion criteria were all emergency cases undergoing intestinal stomas for treatment of either traumatic bowel injuries or acute abdominal surgical emergencies. Results: With a mean age of 45.18 years, 60 patients in all were evaluated. Males were 65% and females were 35%. End ileostomy with mucous fistula (33.3%) and loop transverse colostomy (18.30%) were the two stomas that were constructed most frequently. Intestinal obstruction (41.7%) was the most often reported indication of stoma formation. Complications of the peristomal skin made up the majority of cases (61.90%). Conclusions: This work significantly advances our understanding of stoma problems and their prevention to some extent through pre-operative soma site marking, good surgical technique, an experienced surgeon, a stoma therapy nurse, and patient education to enhance the care and quality of life for those who have stomas.

Quadratus Lumborum block as primary anesthetic technique for colostomy procedure: a case report

Abstract An elderly patient was admitted to the hospital due to an enterovesical fistula and a terminal colostomy was proposed. The patient had a high anesthetic risk and thus a quadratus lumborum block was chosen as the sole anesthetic technique. This block has been described to provide both somatic and visceral analgesia to the abdomen. In fact, it yielded good anesthetic conditions to perform the procedure and allowed the patient to be hemodynamically stable and comfortable throughout the case. The postoperative period was uneventful.

Perfil Biossociodemográfico e Digital de Participantes de uma Intervenção Educativa Online sobre Colostomia / Biosociodemographic and Digital Profile of Participants in an Online Educational Intervention on Colostomy / Perfil Biosociodemográfico y Digital de los Participantes en una Intervención Educativa Online Sobre Colostomía

Objetivo:Identificar o perfil biossociodemográfico e digital das pessoas com colostomia e dos cuidadores que participaram da intervenção educativa online sobre colostomia. Método: Estudo transversal realizado com 20 pessoas com colostomia e 32 cuidadores, no período de setembro/novembro de 2020, em um centro integrado de saúde de Teresina, Piauí. Utilizaram-se instrumentos de caracterização sociodemográfica e clínica, acesso ao computador e à internet e proficiência digital básica, todos submetidos à análise estatística. Resultados: Das pessoas com colostomia e cuidadores, 60% eram do sexo masculino e 75% do feminino. Predominou a colostomia temporária (55%) de cor vermelho vivo e formato regular (80%). A maioria dos cuidadores tinha ocupação laboral (46,9%), e 8 horas/semanais eram dedicadas ao cuidado. O grau de proficiência digital foi baixo (76,9%). Conclusão: A identificação do perfil biossociodemográfico e digital dos participantes pode contribuir na adoção de estratégias educativas conforme a maturidade digital ou a necessidade de suporte para o uso de tecnologias, para otimização do cuidado em saúde e qualificação da assistência prestada.

Objective:To identify the biosociodemographic and digital profile of people with colostomy and caregivers who participated in the online educational intervention on colostomy. Method: Cross-sectional study carried out with 20 people with colostomy and 32 caregivers, in the period of September/November 2020, in an integrated health center in Teresina, Piauí, Brazil. Sociodemographic and clinical characterization instruments, computer and internet access, and basic digital proficiency submitted to statistical analysis were used. Results: Among people with colostomy and caregivers, 60% were male and 75% female. Temporary colostomy (55%) with bright red color and regular shape (80%) predominated. Most caregivers had a job (46.9%), and 8 hours/week were dedicated to care. The degree of digital proficiency was low (76.9%). Conclusion: The identification of the biosociodemographic and digital profile of the participants can contribute to the adoption of educational strategies according to digital maturity or the need for support for the use of technologies, to optimize health care and qualify the assistance provided.

Objetivo:Identificar el perfil biosociodemográfico y digital de personas con colostomía y cuidadores que participarían de la intervención educativa en línea sobre colostomía. Método: Estudio transversal, realizado con 20 personas con colostomía y 32 cuidadores, en el período de septiembre/noviembre de 2020, en un Centro Integrado de Salud de Teresina, Piauí. Se utilizaron instrumentos de caracterización sociodemográfica y clínica, acceso a computador e internet y competencia digital básica sometidos a análisis estadístico. Resultados: La mayoría de las personas con colostomía y cuidadores eran hombres (60%) y mujeres (75%), respectivamente. Predominó la colostomía temporal (55%) de color rojo vivo y forma regular (80%). La mayoría de los cuidadores tenían trabajo (46,9%), y se dedicaban al cuidado 8 horas/semana. El grado de competencia digital fue bajo (76,9%). Conclusión: La identificación del perfil biosociodemográfico y digital de los participantes puede contribuir para la adopción de estrategias educativas de acuerdo con la madurez digital o la necesidad de apoyo para el uso de tecnologías, para optimizar la atención en salud y calificar la asistencia brindada

Custo Direto com Tecnologias Para Manejo da Colostomia Definitiva em um Serviço Especializado / Direct Cost of Technologies for Management of Definitive Colostomy in a Specialized Service / Costo Directo de Tecnologías Para el Manejo de la Colostomía Definitiva en un Servicio Especializado

Objetivos:Identificar o custo direto de um serviço especializado com o uso de equipamentos coletores e adjuvantes e compará-lo com o custo simulado da autoirrigação intestinal em pessoas com colostomia definitiva. Método: Estudo descritivo-exploratório conduzido por meio da abordagem quantitativa nos moldes de estudo de casos múltiplos. A amostra por conveniência foi composta de 22 participantes cadastrados em um serviço especializado do norte de Minas Gerais. A coleta de dados foi realizada em prontuários do período de janeiro de 2019 a janeiro de 2020. Resultados: Dos participantes, 59,1% apresentaram complicações relacionadas à estomia e pele periestomia. Em relação aos equipamentos coletores/adjuvantes, o custo variou de 2.340,00 a R$ 5.535,00, custo médio de R$ 4.050,01 e desvio padrão amostral de R$ 770,31. O custo direto médio com autoirrigação de colostomia foi de R$ 3.793,44. Conclusão: O custo direto médio dos equipamentos coletores/adjuvantes foi superior ao da autoirrigação de colostomia, impactado pela presença de complicações e pelo valor do protetor de colostomia.

Objectives:To identify the direct cost of a specialized service with the use of collection equipment and adjuvants and to compare it with the simulated cost of intestinal self-irrigation in people with permanent colostomy. Method: Descriptive-exploratory study conducted through a quantitative approach in the form of multiple-case studies. The convenience sample consisted of 22 participants registered in a specialized service in the north of Minas Gerais, Brazil. Data collection was carried out in medical records from January 2019 to January 2020. Results: Among the participants, 59.1% had complications related to the ostomy and peristomal skin. Regarding collector/adjuvant equipment, the cost ranged from R$ 2,340.00 to R$ 5,535.00, average cost of R$ 4,050.01, and sample standard deviation of R$ 770.31. The average direct cost with colostomy self-irrigation was R$ 3,793.44. Conclusion: The average direct cost of collection/adjuvant equipment was higher than that of colostomy self-irrigation, impacted by the presence of complications and the value of the colostomy protector.

Objetivos:Identificar o custo direto de um serviço especializado com o uso de equipamentos coletores e adjuvantes e compará-lo com o custo simulado da autoirrigação intestinal em pessoas com colostomia definitiva. Método: Estudo descritivo-exploratório conduzido por meio da abordagem quantitativa nos moldes de estudo de casos múltiplos. A amostra por conveniência foi composta de 22 participantes cadastrados em um serviço especializado do norte de Minas Gerais. A coleta de dados foi realizada em prontuários do período de janeiro de 2019 a janeiro de 2020. Resultados: Dos participantes, 59,1% apresentaram complicações relacionadas à estomia e pele periestomia. Em relação aos equipamentos coletores/adjuvantes, o custo variou de 2.340,00 a R$ 5.535,00, custo médio de R$ 4.050,01 e desvio padrão amostral de R$ 770,31. O custo direto médio com autoirrigação de colostomia foi de R$ 3.793,44. Conclusão: O custo direto médio dos equipamentos coletores/adjuvantes foi superior ao da autoirrigação de colostomia, impactado pela presença de complicações e pelo valor do protetor de colostomia.

Clinical study of stoma closure: its complications and management

Background: A stoma is a surgically formed exteriorization of the ileum or colon to the anterior surface of wall of abdomen. There are various reasons for the formation of fecal stoma then the most common reasons comprise blunt abdominal trauma, carcinoma, inflammatory bowel disease. Formation of stoma can disturb the individual equally psychologically and physically. In accumulation, complications during stoma are very common. Methods: The study was carried out in 50 patients between June 2021 to November 2022. All the patients who undergone stoma closure and fulfilled inclusion criteria were taken as study population. Patients of all age groups undergone stoma closure for non-malignant condition were included in the study. Stoma closure of the patients who were operated for malignancy, tuberculosis and inflammatory bowel disease were not included in the study. This study population were observed for different complications, complications in different techniques and complications in different stoma closure interval. Results: Less post operatively complications were seen in early stoma closure and Intraoperatively by using direct stoma closure technique. By using the subcutaneous drain placement, we can reduce chances of wound infection and wound dehiscence. Conclusions: Postoperative complication in stoma closure can be reduced by adapting proper technique and doing closure at appropriate time interval.

Evaluation of the outcome of linear stapler anastomosis in comparison to hand-sewn anastomosis in elective loop transverse colostomy closure in children: a study in a tertiary care hospital, Dhaka, Bangladesh

Background: Conventional hand suture technique of intestinal anastomosis has been in vogue for decades. Staplers which developed to simplify surgery began to have significant impact. Objective were to see outcome of linear stapler anastomosis in comparison to hand-sewn anastomosis in elective loop transverse colostomy closure in children.Methods: This prospective interventional study was carried out in the department of pediatric surgery, Dhaka medical college hospital, Dhaka from January 2018 to December 2019 over a period of 2 years. Forty-seven patients who underwent loop transverse colostomy closure were included in this study. Patients were allocated by purposive sampling into two groups, group A (linear stapler anastomosis) and group B (hand-sewn anastomosis).Results: Mean age of the patients were 5.79�23 years and 4.21�13 years in linear stapler anastomosis group and hand-sewn anastomosis group respectively. Male to female ratio was 1.2:1 in linear stapler anastomosis group and 5.25:1 in hand-sewn anastomosis group. The mean duration of return of bowel movements (passage of flatus after surgery) in linear stapler method was 32.82�04 hours and in hand sewn method was 40.56�35 hours (p<0.05). Oral feeding was started earlier in patients who underwent linear stapler anastomosis (3.18�39 days), as compared to hand-sewn anastomosis (4.16�37 days) (p?0.001). The mean cost in linear stapler method was Tk. 4072�8 and in hand sewn method was Tk. 1440�2. Anastomotic leakage was lower (4.5%) in linear stapler anastomosis than that in hand-sewn anastomosis (20.0%) (p>0.05).Conclusions: Stapling technique can be used safely and effectively as a part of modern Surgeon`s armory and one should be equally expert with stapler guns as with needle holders and sutures.

CUIDADOS DE ENFERMAGEM FRENTE AO PACIENTE COM ESTOMIA INTESTINAL: UMA REVISÃO INTEGRATIVA / NURSING CARE FRONT OF PATIENTS WITH INTESTINAL STOMA: AN INTEGRATIVE REVIEW

Objetivo: descrever os cuidados de enfermagem na assistência prestada ao paciente com estomia intestinal apresentados na literatura. Método: revisão integrativa da literatura baseada em obras secundárias, publicadas no período de 2017 a 2022. Foi realizado o levantamento em ambiente virtual na Biblioteca Virtual de Saúde (BVS), as bases: Lilacs, Medline, BDENF. no Portal de Periódicos CAPES as bases: Cinahl e em uma busca livre de textos completos na Scientific Electronic Library Online (Scielo) Resultados: foram selecionados 14 artigos para a síntese. E esses estudos foram expostos com as informações: autores, ano de publicação e país; objetivo; método, tamanho e tipo de estudo; principais achados; conclusão. Discussão: se tratando da atuação da enfermagem frente a estomia, pode-se afirmar que o enfermeiro possui uma grande responsabilidade. Um dos cuidados com grande importância é o olhar humano e holístico para esse indivíduo ostomizado. focando na pessoa ostomizada, afirma que o enfermeiro deve focar no autocuidado. Tendo em vista que é um conceito amplo, o mesmo está ligado a vários fatores que o indivíduo se relaciona em vida, como: bem-estar, saúde, sobrevivência, autoaprendizagem. o cuidado de educar a pessoa desde a confirmação da confecção do estoma é necessário, dessa forma, o enfermeiro deve planejar seu cuidado desde a confirmação da confecção do estoma até a alta hospitalar. Conclusão: este estudo conseguiu evidenciar os principais cuidados de enfermagem descrito na literatura para serem realizados em pessoas com ostomia. adequado a sua finalidade e útil para a assistência de enfermagem ao paciente internado estomizado.

Objective: to describe the nursing care provided to patients with intestinal ostomy presented in the literature. Method: integrative literature review based on secondary works, published from 2017 to 2022. The survey was carried out in a virtual environment in the Virtual Health Library (BVS), the bases: Lilacs, Medline, BDENF. in the CAPES Periodicals Portal the bases: Cinahl and in a free search of full texts in the Scientific Electronic Library Online (Scielo) Results: 14 articles were selected for the synthesis. And these studies were exposed with the information: authors, year of publication and country; objective; method, size and type of study; main findings; conclusion. Discussion: when it comes to the role of nursing in the face of ostomy, it can be said that the nurse has a great responsibility. One of the most important care is the human and holistic look for this ostomized individual. focusing on the ostomized person, states that nurses should focus on selfcare. Considering that it is a broad concept, it is linked to several factors that the individual relates to in life, such as: well-being, health, survival, self-learning. the care of educating the person from the confirmation of the stoma construction is necessary, in this way, the nurse must plan their care from the confirmation of the stoma construction until hospital discharge. Conclusion: this study was able to highlight the main nursing care described in the literature to be performed in people with ostomy. suitable for its purpose and useful for nursing care for inpatients with a stoma.

Laparoscopic Deloyers Procedure as a Salvage Technique for Colorectal Anastomosis: An Alternative to Total Colectomy

Introduction: The Deloyers procedure is a valuable technique used in reconstructing bowel transit following an extended left colectomy, a Hartmann-type colostomy, or repeated colon resections. It enables the creation of a tension-free colorectal or coloanal anastomosis. Case presentation: A 60-year-old female patient presented for consultation regarding the closure of a colostomy. Her medical history included segmental colectomy of the sigmoid and descending colon, resulting in a Hartmann-type colostomy due to complicated diverticulitis. The patient underwent laparoscopic surgery, during which a segment of the transverse colon with a short mesocolon was identified. Due to the complete release of the colon, a colorectal anastomosis could not be performed. As an alternative to preserving the ileocecal valve and achieving a tension-free colorectal anastomosis, the patient underwent the Deloyers procedure. Discussion: The Deloyers procedure involves tension-free anastomosis between the right colon and the rectum or anus. It includes complete mobilization and a 180° counterclockwise rotation of the hepatic angle and the right colon. The right and middle colic vessels are divided, while preserving the ileocolic pedicle and the ileocecal valve, thus avoiding the need for total colectomy and ileorectal anastomosis, which may yield unsatisfactory functional outcomes. Conclusion: The Deloyers procedure represents a viable alternative to ileorectal or ileoanal anastomosis, offering satisfactory functional outcomes.

Introducción: el procedimiento de Deloyers es una técnica útil en la reconstrucción del tránsito intestinal posterior a una colectomía izquierda ampliada, colostomía tipo Hartmann o resecciones colónicas iterativas, pues asegura una anastomosis colorrectal o coloanal sin tensión. Presentación del caso: una mujer de 60 años acudió a consulta para el cierre de una colostomía, con antecedente de colectomía segmentaria del sigmoides y colon descendente derivada con colostomía tipo Hartmann por diverticulitis complicada. Fue llevada a cirugía laparoscópica, en la que se encontró un segmento de colon transverso con meso corto y al liberarse completamente no se logró realizar la anastomosis colorrectal, por lo que se decidió realizar el procedimiento de Deloyers como alternativa para conservar la válvula ileocecal y obtener la anastomosis colorrectal libre de tensión. Discusión: el procedimiento de Deloyers consiste en la unión del colon derecho y recto o ano libre de tensión después de realizar la movilización completa y rotación de 180° en sentido antihorario del ángulo hepático y el colon derecho, en el que se seccionan los vasos cólicos derecho y medio, con preservación del pedículo ileocólico y la válvula ileocecal, para evitar la necesidad de una colectomía total y una anastomosis ileorrectal, para la cual los resultados funcionales pueden ser insatisfactorios. Conclusión: el procedimiento de Deloyers es una alternativa viable a la anastomosis ileorrectal o ileoanal con resultados funcionales satisfactorios.

A case report of a pediatric patient with Hirschsprung’s disease

The objective is to describe an uncommon case of Hirschsprung's disease (HD), also called congenital megacolon. The lack of neuronal ganglion cells from the submucosal and muscular nerve plexuses throughout a segment of varied length characterizes HD. Approx 94% of HD cases are diagnosed below the age of 5 years. A 3 years old male patient was admitted to the male surgery ward under a pediatric surgeon with the chief complaints of chronic constipation since birth with a history of delayed passage of meconium. The patient was diagnosed with a case of HD at the age of 1 year for which he was operated on colostomy was performed with multiple biopsies from narrowed rectosigmoid, from the transitional zone, and from colostomy stoma which confirmed the decision to make colostomy at the ganglionated segment of the colon based on the clinical picture during surgery. Biopsy report of narrowed rectosigmoid segment showed the absence of ganglion cells, while colostomy stoma and dilated proximal colon showed the presence of ganglion cells. The patient underwent a surgical procedure named pull-through surgery for HD, a martin's modification of the Duhamel operation.

Técnica de la incisión y cierre de piel en "punto de mira" para la reversión de estoma. Experiencia en el Centro Médico Nacional "La Raza", México / Gunsight skin incision and closure technique for stoma reversal. Experience in Centro Médico Nacional "La Raza", México

RESUMEN Antecedentes: la cirugía de restitución del tránsito intestinal presenta complicaciones posoperatorias tales como infección de sitio quirúrgico, asociado a percepción de pobre resultado cosmético por parte de los pacientes. Objetivo: describir la técnica quirúrgica de incisión y cierre de piel en "punto de mira" para la reversión de estoma y los resultados posoperatorios. Material y métodos: entre noviembre de 2020 y mayo de 2021 se realizó esta técnica a 15 pacientes con estatus de colostomía e ileostomía. Se analizaron los resultados transoperatorios y posoperatorios. Resultados: edad promedio: 38±2,5 años, índice de masa corporal: 28±1,5 kg/m2, tiempo de estadía hospitalaria: 4±2 días. La técnica presentó buena exposición de tejidos y ningún paciente presentó infección de sitio quirúrgico. A los 30 días del alta, el 100% de los pacientes expresaron alta satisfacción por el resultado estético evidenciado mediante la escala Likert 3. Conclusión: la utilización de este procedimiento ofrece ventajas técnicas, y alta satisfacción de los pacientes.

ABSTRACT Background: Stoma reversal has postoperative complications such as surgical site infection associated with patients' perception of a poor cosmetic outcome. Objective: The aim of this study is to describe the gunsight skin incision and closure technique for stoma reversal and the postoperative results. Material and methods: Between November 2020 and May 2021, this technique was performed on 15 patients with colostomy and ileostomy. The intraoperative and postoperative results were analyzed. Results: Mean age was 38 ± 2.5 years, body mass index was 28±1.5 kg/m2, and length of hospital stay was 4 ± 2 days. The technique provided good tissue exposure and no patients presented surgical site infection. Thirty days after discharge 100% of patients reported high satisfaction with the cosmetic result as evidenced by the 3-point Likert scale. Conclusion: This procedure offers technical advantages and high patient satisfaction.

Risk factors of postoperative recurrence after parastomal hernia repair / 中华普通外科杂志

Objective:To investigate the risk factors of postoperative recurrence of parastomal hernia repair.Methods:The clinical and follow-up data of 128 patients undergoing parastomal hernia repair at the the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology from Jan 1, 2013 to Dec 31, 2022 was analyzed retrospectively.Results:Postoperative recurrence was confirmed in 32 patients during follow-up, and the recurrence rates were 13.8% , 24.8% and 25.0% at 1',3' and 5 years .Univariate analysis showed that body mass index (BMI) , chronic obstructive pulmonary disease (COPD), type of stoma, prophylactic stoma displacement, and surgical options were the risk factors for recurrence after parastomal hernia repair. Multiple Logistic regression analysis showed that BMI, COPD, prophylactic stoma displacement, and surgical options were independent risk factors for the recurrence after parastomal hernia ( P< 0.05). Conclusion:The occurrence of hernia recurrence after parastomal hernia repair is closely related to patients' BMI, COPD, prophylactic stoma displacement and the surgical options.

Quality of life of people with intestinal ostomies and associated factors / Calidad de vida de personas con estomas intestinales y factores asociados / Qualidade de vida das pessoas com estomias intestinais e fatores associados

ABSTRACT Objective: to assess the quality of life of individuals with intestinal ostomies and its association with sociodemographic and clinical factors. Method: a cross-sectional and correlational study conducted between August 2019 and December 2021, involving individuals with intestinal ostomies registered at the Orthotics and Prosthetics Service of the Municipal Health Department of São Luís-Maranhão. The questionnaires used included a sociodemographic one, a clinical one, and the City Of Hope - Quality Of Life - Ostomy Questionnaire (COH-QOL-OQ). The statistical analyses were conducted using the SPSS Statistics 20.1 software for Windows, with a 5% significance level. Normality was verified using the Shapiro-Wilk test, and the correlations between independent and dependent variables were assessed using paired t-tests. Results: the sample consisted of 154 participants, mostly men (62.6%), with a mean age of 49.94 years old and Incomplete Elementary School (35%). The majority had colostomies (81.2%), temporary (61%), and cancer as etiology (47.4%). In terms of quality of life, the mean scores for the spiritual well-being domain (8.45) stood out, followed by the physical (4.05), psychological (5.85) and social (6.33) domains. The association between sociodemographic/clinical factors, and quality of life was statistically significant (p≤0.05) for religion, schooling, type and characteristics of the household, ostomy permanence and complications, post-ostomy employment, presence of spouse, physical activity, and access to health services. Etiology of the ostomy was found to be significantly associated with the physical (p=0.03), psychological (p=0.01) and social (p=0.01) domains, as well as overall (p=0.05). Conclusion: the study revealed a significant association for the physical, psychological, social and spiritual domains, impacting the quality of life and care practices for individuals with ostomies and their families.

RESUMEN Objetivo: evaluar la calidad de vida de personas con estomas intestinales y la asociación con factores sociodemográficos y clínicos. Métodos: estudio transversal y correlacional realizado entre agosto de 2019 y diciembre de 2021 con personas ostomizadas registradas en el Servicio de Órtesis y Prótesis de la Secretaría Municipal de Salud de São Luís-Maranhão. Se utilizó un cuestionario sociodemográfico, uno clínico y el City Of Hope - Quality Of Life - Ostomy Questionnary (COH-QOL-OQ). Los análisis estadísticos se procesaron en el programa de software SPSS Statistics 20.1 para Windows, con nivel de significancia del 5%. En la prueba de Shapiro-Wilk se verificó la normalidad y, con la prueba t pareada, las correlaciones de las variables independientes y dependientes. Resultados: la muestra estuvo compuesta por 154 participantes, con mayoría de hombres (62,6%), media de edad de 49,94 años, con estudios primarios incompletos (35%), colostomías (81,2%), temporarias (61%) y cáncer como etiología (47,4%). En relación con la calidad de vida, se destacaron los valores medios correspondientes a los dominios de bienestar espiritual (8,45), físico (4,05), psicológico (5,85) y social (6,33). La asociación entre factores sociodemográficos/clínicos y calidad de vida presentó significancia estadística (p ≤ 0,05) para religión, nivel de estudios, tipo y característica del hogar, permanencia del estoma y complicaciones, trabajar después del estoma, presencia de cónyuge, actividad física y acceso a servicios de salud. Se verificó que la mayor significancia de la etiología del estoma correspondió a los dominios físico (p=0,03), psicológico (p=0,01), social (p=0,01) y general (p=0,05). Conclusión: el estudio demostró una asociación significativa para los dominios físico, psicológico, social y espiritual, con efecto sobre la calidad de vida y en las prácticas de atención a personas con estomas y sus familiares.

RESUMO Objetivo: avaliar a qualidade de vida das pessoas com estomias intestinais e associação com fatores sociodemográficos e clínicos. Método: estudo transversal e correlacional realizado entre agosto de 2019 e dezembro de 2021, com pessoas estomizadas cadastradas no Serviço de Órtese e Prótese da Secretaria Municipal de Saúde de São Luís-Maranhão. Utilizou-se questionários sociodemográfico, clínico e City OF Hope - Quality Of Life - Ostomy Questionnary (COH-QOL-OQ). As análises estatísticas foram processadas pelo Software SPSS Statistics 20.1 para Windows, nível de significância 5%. No teste Shapiro-Wilk verificou-se a normalidade e no teste-t pareado as correlações das variáveis independentes e dependente. Resultados: amostra composta por 154 participantes, maioria homens (62,6%), idade média 49,94 anos, com ensino fundamental incompleto (35%), colostomia (81,2%), temporária (61%) e câncer como etiologia (47,4%). Em relação à qualidade de vida, destacaram-se as médias para os domínios bem-estar espiritual (8,45), físico (4,05), psicológico (5,85) e social (6,33). A associação entre fatores sociodemográficos, clínicos e qualidade de vida foi estatisticamente significante (p ≤ 0,05) para religião, escolaridade, tipo e característica do domicílio, permanência da estomia e complicações, trabalho pós-estomia, presença de cônjuge, atividade física e acesso ao serviço de saúde. Verificou-se a maior significância da etiologia da estomia para domínios físico (p=0,03), psicológico (p=0,01), social (p=0,01) e geral (p=0,05). Conclusão: o estudo mostrou associação significante para os domínios físico, psicológico, social e espiritual, com impacto a qualidade de vida e nas práticas de cuidado às pessoas com estomias e seus familiares.