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1.
rev.cuid. (Bucaramanga.2010) ; 13(1): 1-18, 20211213.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1369170

ABSTRACT

Introducción: los estomas intestinales representan un impacto significativo en la calidad de vida de las personas; sin embargo, estos deben revertirse después de haberse restituido el tránsito intestinal o la resolución del proceso inflamatorio inicial. Por otro lado, la negación de la persona para su reversión puede deberse a la falta de información y orientación por parte de los profesionales de la salud. Por lo anterior es importante identificar las intervenciones de Enfermería en la atención de la persona con reversión del estoma intestinal. Materiales y métodos: se realizó una revisión integrativa de la literatura de alcance descriptivo en el período comprendido entre los años 2015 a 2020, a través de las bases de datos Wos, Pubmed, Scopus, Scielo y Cochrane. Se seleccionaron 36 artículos que cumplieron con los criterios de inclusión y exclusión con el respectivo análisis metodológico. Resultados: Se identificaron las siguientes intervenciones de Enfermería, para el preoperatorio: valoración preoperatoria, preparación intestinal y seguimiento a comorbilidades. El intraoperatorio: profilaxis, preparación de la piel, técnica quirúrgica y cierre de la pared abdominal. En el posoperatorio: cuidado de la herida quirúrgica, calidad de vida y educación. Discusión: es importante la reflexión sobre el tiempo de reversión, la técnica quirúrgica y la importancia de las intervenciones por Enfermería. Conclusión: Enfermería cumple un papel importante en la reversión del estoma, no solo por los cuidados físicos y la educación que se brinda, sino también en las intervenciones aplicables al contexto social y emocional que afectan el estilo de vida de la persona.


Introduction: Intestinal stomas have a significant impact on people's quality of life. However, these should be reversed after gastrointestinal transit has been restored or the initial inflammatory response has gone. In addition, patients may refuse to reverse them due to a lack of information and guidance from healthcare professionals. Therefore, it is important to identify nursing interventions in caring for patients with stoma reversal. Materials and Methods: An integrative literature review was conducted in WOS, PubMed, Scopus, SciELO and Cochrane databases published between 2015 and 2020. 36 articles were selected based on inclusion and exclusion criteria with their methodological analysis. Results: The following nursing interventions were identified: preoperative assessment, bowel preparation and follow-up of comorbidities in the preoperative period; prophylaxis, skin preparation, surgical technique and abdominal wall closure in the intraoperative period; surgical wound care, quality of life and education in the postoperative period. Discussion: It is essential to reflect on reversal time, surgical technique and the importance of nursing interventions. Conclusions: Nursing plays an important role in stoma reversal not only because of physical care and education provided, but also the interventions applicable to social and emotional contexts affecting the patient's lifestyle.


Introdução: Os estomas intestinais representam um impacto significativo na qualidade de vida dos indivíduos; entretanto, eles devem ser revertidos após o trânsito intestinal ter sido restaurado ou o processo inflamatório inicial ter sido resolvido. Por outro lado, a recusa de uma pessoa em revertê-los pode ser devido à falta de informação e orientação dos profissionais de saúde. Portanto, é importante identificar intervenções da Enfermagem no cuidado da pessoa com reversão do estoma intestinal. Materiais e métodos: no período de 2015 a 2020 foi realizada uma revisão integrativa da literatura de escopo descritivo, através das bases de dados Wos, Pubmed, Scopus, Scielo e Cochrane. Foram selecionados 36 artigos que preenchiam os critérios de inclusão e exclusão com a respectiva análise metodológica. Resultados: Foram identificadas as seguintes intervenções de Enfermagem, para o período pré-operatório: avaliação pré-operatória, preparação intestinal e monitoramento de comorbidades. Intra-operatório: profilaxia, preparação da pele, técnica cirúrgica e fechamento da parede abdominal. Pós-operatório: tratamento de feridas cirúrgicas, qualidade de vida e educação. Discussão: é importante refletir sobre o tempo de reversão, a técnica cirúrgica e a importância das intervenções de Enfermagem. Conclusão: A Enfermagem desempenha um papel importante na reversão do estoma, não apenas nos cuidados físicos e na educação fornecida, mas também nas intervenções aplicáveis ao contexto social e emocional que afetam o estilo de vida da pessoa.


Subject(s)
Humans , Male , Female , Colostomy , Ileostomy , Nursing
2.
Estima (Online) ; 19(1): e1521, jan.-dez. 2021.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1291477

ABSTRACT

Objetivo:Analisar as percepções dos pacientes com câncer colorretal em uso de colostomia sobre os cuidados de enfermagem das unidades de internação em oncologia de um hospital do oeste de Santa Catarina. Métodos: Estudo descritivo-exploratório de abordagem qualitativa realizado nas unidades de internação em oncologia do Hospital Regional do Oeste, no período de janeiro a agosto de 2020, por meio de um questionário contendo dados sociodemográficos e entrevista semiestruturada, aplicado a 20 pacientes com câncer colorretal em uso de colostomia. Os dados foram analisados por meio da Análise de Conteúdo de Laurence Bardin. Resultados: Os resultados apontaram prevalência de colostomizados do sexo masculino, com idade média de 60,25 anos, casados, aposentados e com ensino fundamental incompleto. A partir da análise qualitativa das entrevistas surgiu a categoria: percepções dos pacientes sobre os cuidados de enfermagem, a qual foi subdividida em: cuidados de enfermagem com a bolsa e a estomia e cuidados de enfermagem na internação. Conclusão: Ao término da pesquisa, conclui-se que os colostomizados percebem que a equipe de enfermagem realiza os cuidados essenciais à bolsa e à estomia, incluindo sua troca e higiene durante a internação, atendendo às necessidades dos pacientes. Além disso, fornecem orientações importantes sobre o uso dos dispositivos, promovendo educação em saúde.


Subject(s)
Colostomy , Colorectal Neoplasms , Qualitative Research , Enterostomal Therapy , Medical Oncology , Nursing Care
3.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 579-584, 01-dic-2021. ilus
Article in Spanish | LILACS | ID: biblio-1357673

ABSTRACT

Introducción: el sarcoma fibromixoide de bajo grado (LGFMS) se considera un tumor de tejidos blandos raro, que tiene tendencia a surgir del tronco y de las extremidades inferiores, su localización en el área intraabdominal se considera poco común. Objetivo: describir un caso de LGFMS primario de colon transverso perforado con metástasis hepática. Caso clínico: describimos el caso de un paciente masculino de 57 años con dolor abdominal de inicio súbito; en la cirugía se encontró un tumor con absceso y perforación en el colon transverso que infiltraba hasta la raíz del mesenterio. Se realizó hemicolectomía izquierda extendida con colostomía de colon ascendente. Más tarde, en una exploración posoperatoria, se encontró que tenía enfermedad hepática metastásica. Conclusiones: este caso es único en términos de ubicación y presentación. Es un recordatorio del diagnóstico diferencial del dolor abdominal agudo. Hasta donde sabemos, es el primer caso de LGFMS del colon con metástasis hepática sincrónica.


Background: Low grade fibromyxoid sarcoma (LGFMS) is considered a rare soft tissue tumor and has a tendency to arise from deep soft tissue of the trunk and lower extremities, the intraabdominal area is considered a rare location. Objective: To describe the first case of a LGFMS arising from the transverse colon with liver metastasis Clinical case: We describe a 57-years-old male patient with abdominal pain of sudden onset; at surgery he was found to have an abscessed tumor in the transverse colon that infiltrated to mesentery root. An extended left hemicolectomy was performed with ascending colon colostomy. Later on, a postoperative scan he was found to have metastatic liver disease Conclusions: This case is unique in terms of the location and presentation. It's a reminder of differential diagnosis of acute abdominal pain. To our knowledge is the first case of a LGFMS of the colon with synchronous liver metastasis.


Subject(s)
Humans , Male , Female , Colonic Neoplasms , Intestinal Perforation , Neoplasm Metastasis , Sarcoma , Tertiary Healthcare , Colostomy , Abdominal Pain , Colectomy , Colon , Colon, Ascending , Liver Diseases
4.
J. coloproctol. (Rio J., Impr.) ; 41(3): 242-248, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1346417

ABSTRACT

Introduction: There has been conclusive evidence that defunctioning stoma with either transverse colostomy or ileostomy mitigates the serious consequences of anastomotic leakage. However,whether transverse colostomy or ileostomy is preferred for defunctioning a rectal anastomosis remains controversial. The present study was designed to identify the best defunctioning stoma for colorectal anastomosis. Objective: To improve the quality of life in patients with rectal resection and anastomosis and reduce the morbidity before and after closure of the stoma. Patients and Methods The present study included 48 patients with elective colorectal resection who were randomly arranged into 2 equal groups, with 24 patients each. Group I consisted of patients who underwent ileostomy, and group II consisted of patients who underwent colostomy as a defunctioning stoma for a low rectal anastomosis. All surviving patients were readmitted to have their stoma closed and were followed-up for 6 months after closure of their stomas. All data regarding local and general complications of construction and closure of the stoma of the two groups were recorded and blotted against each other to clarify the most safe and tolerable procedure. Results: We found that all nutritional deficiencies, dehydration, electrolytes imbalance, peristomal dermatitis, and frequent change of appliances are statistically more common in the ileostomy group, while stomal retraction and wound infection after closure of the stoma were statistically more common in the colostomy group. There were no statistically significant differences regarding the total hospital stay and mortality between the two groups. Conclusion and Recommendation: Ileostomy has much higher morbidities than colostomy and it also has a potential risk of mortality; therefore, we recommend colostomy as the ideal method for defunctioning a distal colorectal anastomosis. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Rectum/surgery , Anastomosis, Surgical/methods , Surgical Stomas/adverse effects , Colostomy , Ileostomy , Treatment Outcome
5.
J. coloproctol. (Rio J., Impr.) ; 41(3): 286-288, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1346419

ABSTRACT

Background: A colostomy is a surgical approach that creates an opening for the colon, or/and large intestine through the abdomen. Anorectal malformations are a group of abnormalities of the rectum and anus that are present at birth. Objective: To analyze the common complications of colostomy in anorectal formations. Methods: This was a retrospective study conducted on 50 temporary colostomies performed in children at the Surgical Department of the Abu Ghraib General Hospital in the period from January 2018 to January 2020. Information was collected regarding the patients' age, sex, body weight, associated anomalies, colostomy types and sites, and the indications and complications of colostomies. Results: A total of 44 (88%) cases were reported in the children's 1st month of life. The ratio of male to female was 1:1. Pelvic colostomy was performed in 48 (96%) patients, as 40 (80%) children underwent a loop-type, and 8 (16%) patients underwent doublebarrel colostomy. Transverse colostomy was performed on two patients. Prolapse occurred in 50% of the patients, and skin excoriations occurred in 22% . A total of 10% of the children developed sepsis. Bleeding was seen in 4% of the children after colostomy performance. Stenosis presented in 6% of the children, and this was corrected by repeated dilatation and re-fashioning. Obstruction of intestines was observed in one patient. The retraction developed in 6% of patients. Conclusions: Imperforate anus was themost common indication for stoma formation in the pediatric age group. Loop colostomy was the most common type used, and it had the highest rate of complications. Prolapses and skin excoriation were the most common complications found. (AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Colostomy/adverse effects , Anorectal Malformations/surgery , Surgical Stomas
6.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367459

ABSTRACT

RESUMO Introdução: A cirurgia de confecção de ostomia é um procedimento corriqueiro que envolve diversos fatores ambientais, psicossociais e técnicos. Porém este procedimento gera limitações na vida do paciente, seja ele permanente ou temporário. Objetivo: Descrever o perfil epidemiológico dos pacientes que realizaram ostomias no Hospital Nossa Senhora da Conceição de Tubarão-SC e associar com suas comorbidades de acordo com o Índice de Comorbidades de Charlson (ICC). Métodos: Estudo de corte transversal descritivo, incluiu 79 pacientes ostomizados durante o período de 2008 a 2018. Resultados: Houve maior prevalência do sexo masculino (60,8%), a principal causa foi neoplasia de cólon (41,8%), as complicações tardias mais frequentes foram hérnia (21,5%), prolapso (17,7%) e fistula (15,2%). A pontuação do ICC foi a mais elevada (maior gravidade) nos pacientes com neoplasia de cólon. Os pacientes do sexo masculino apresentaram oito vezes mais risco de prolapso e três vezes mais risco de hérnia. Pacientes com ostomia permanente apresentaram ICC mais elevado que os de temporária. Conclusão: Estratégias de prevenção e avaliação das comorbidades são fundamentais para o seguimento de pacientes ostomizados. PALAVRA-CHAVE: Estomia, colostomia, ileostomia, comorbidade


ABSTRACT Introduction: Ostomy surgery is a common procedure that involves several environmental, psychosocial and technical factors. However, this procedure generates limitations in the patient's life, whether it is permanent or temporary. Objective: To describe the epidemiological profile of patients who underwent ostomies at the Hospital Nossa Senhora da Conceição in Tubarão-SC and associate it with their comorbidities according to the Charlson Comorbidity Index (CCI). Methods: A descriptive cross-sectional study included 79 ostomy patients from 2008 to 2018. Results: There was a higher prevalence of males (60.8%), the main cause was colon cancer (41.8%), the more frequent late complications were hernia (21.5%), prolapse (17.7%) and fistula (15.2%). The CCI score was the highest (greater severity) in patients with colon cancer. Male patients had an eight-fold higher risk of prolapse and three-fold higher risk of of hernia. Patients with permanent ostomy had higher CCI than temporary ones. Conclusion: Strategies of prevention and assessment of comorbidities are essential for the follow-up of ostomy patients. KEYWORDS: Ostomy, colostomy, ileostomy, comorbidity


Subject(s)
Humans , Ostomy , Colostomy , Ileostomy , Comorbidity
7.
Rev. Esc. Enferm. USP ; 55: e03729, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1279643

ABSTRACT

ABSTRACT Objective: To investigate the effect of the FOCUS-PDCA procedure on the self-care ability of patients undergoing colostomy for rectal cancer. Method: A nonrandomized controlled trial of 160 patients with rectal cancer undergoing colostomy. The control group received routine nursing intervention, and the observation group received the FOCUS-PDCA procedure. The self-care ability of the two groups was investigated 1 week and 1 month after surgery, and a comparative analysis was made between the groups. Results: One week after surgery, the self-care ability of rectal cancer patients with colostomy increased from 39.09 points before implementation of the FOCUS-PDCA procedure to 60.15 points after implementation; an increase of 21.06%. One month after surgery, the self-care ability increased from 61.50 points to 83.13 points after implementation of the FOCUS-PDCA procedure; an increase of 21.63%. Conclusion: Application of the FOCUS-PDCA procedure improved the self-care ability of rectal cancer patients undergoing colostomy, improved their physical and mental health, reduced colostomy complications, and improved their quality of life. The results suggest that it is worth applying FOCUS-PDCA more widely.


RESUMO Objetivo: Investigar o efeito do procedimento FOCUS-PDCA na habilidade de autocuidado de pacientes submetidos a colostomia por câncer retal. Método: Um ensaio clínico não randomizado com 160 pacientes com câncer retal submetidos a colostomia. O grupo controle recebeu intervenção de enfermagem de rotina, e o grupo observação recebeu o procedimento FOCUS-PDCA. A capacidade de autocuidado dos dois grupos foi investigada por 1 semana e 1 mês após a cirurgia, e foi feita uma análise comparativa entre os grupos. Resultados: Em uma semana após a cirurgia a capacidade de autocuidado de pacientes com câncer retal com colostomia aumentou de 39,09 pontos antes da implementação do procedimento FOCUS-PDCA para 60,15 pontos após a implementação; um aumento de 21,06%. Em um mês após a cirurgia, a capacidade de autocuidado aumentou de 61,50 pontos para 83,13 pontos após a implantação do procedimento FOCUS-PDCA; um aumento de 21,63%. Conclusão: A aplicação do procedimento FOCUS-PDCA melhorou a capacidade de autocuidado de pacientes com câncer retal submetidos a colostomia, melhorou sua saúde física e mental, reduziu as complicações da colostomia e melhorou sua qualidade de vida. Os resultados sugerem que vale a pena aplicar o FOCUS-PDCA de forma mais ampla.


RESUMEN Objetivo: Investigar el efecto del procedimiento FOCUS-PDCA sobre la capacidad de autocuidado de pacientes sometidos a colostomia por cáncer de recto. Método: Un ensayo controlado no aleatorizado de 160 pacientes con cáncer de recto sometidos a colostomia. El grupo de control recibió una intervención de enfermería de rutina y el grupo de observación recibió el procedimiento FOCUS-PDCA. La capacidad de autocuidado de los dos grupos se investigó 1 semana y 1 mes después de la cirugía, y se realizó un análisis comparativo entre los grupos. Resultados: En una semana después de la cirugía la capacidad de autocuidado de los pacientes con cáncer de recto con colostomía aumentó de 39,09 puntos antes de la implementación del procedimiento FOCUS-PDCA a 60,15 puntos después de la implementación; un aumento del 21,06%. En un mes después de la cirugía, la capacidad de autocuidado aumentó de 61,50 puntos a 83,13 puntos después de la implementación del procedimiento FOCUS-PDCA; un aumento del 21,63%. Conclusión: La aplicación del procedimiento FOCUS-PDCA mejoró la capacidad de autocuidado de los pacientes con cáncer de recto sometidos a colostomía, mejoró su salud física y mental, redujo las complicaciones de la colostomía y mejoró su calidad de vida. Los resultados sugieren que vale la pena aplicar FOCUS-PDCA de manera más amplia.


Subject(s)
Rectal Neoplasms , Self Care , Oncology Nursing , Aptitude , Colostomy , Quality Management
8.
Rev. Col. Bras. Cir ; 48: e20202644, 2021. graf
Article in English | LILACS | ID: biblio-1155365

ABSTRACT

ABSTRACT Objective: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. Method: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. Results: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). Conclusions: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.


RESUMO Objetivo: elaborar o perfil epidemiológico dos pacientes estomizados atendidos no Serviço de Atenção à Saúde da Pessoa Ostomizada de Juiz de Fora e região (SASPO/JF) e quantificar tanto as patologias que levaram à confecção, quanto as complicações presentes nas estomias. Método: realizado estudo retrospectivo com análise de 496 prontuários de pacientes cadastrados no SASPO/JF ao longo de 30 anos e que permaneciam em atendimento no serviço em junho de 2018. Foram consideradas as seguintes variáveis: idade, sexo, patologia que levou à confecção do estoma, tipo, caráter temporal, localização e complicações das estomias. Resultados: 53,43% dos pacientes eram do sexo masculino e 46,57% do sexo feminino. A média de idade entre os homens foi de 56,24 anos e entre as mulheres foi de 58,40 anos. Oito pacientes apresentaram dois tipos de estomias simultaneamente e o total de 504 estomias foi distribuído da seguinte forma: 340 colostomias (67,46%), 117 ileostomias (23,21%) e 47 urostomias (9,33%). Além disso, 47,65% das colostomias e 76,92% das ileostomias foram temporárias, enquanto todas as urostomias foram permanentes. Em 70,24% dos casos, o motivo para confecção do estoma foi a neoplasia maligna. Foram encontrados 277 estomas com uma ou mais complicações (54,96%). Conclusão: as estomias predominaram em pacientes com mais de 50 anos e o principal diagnóstico que levou à confecção dos estomas foi a neoplasia maligna. As ileostomias apresentaram maior percentual de complicações do que as colostomias e urostomias e, para todos os tipos de estomas, a complicação mais frequente foi a dermatite.


Subject(s)
Humans , Male , Female , Adult , Aged , Ostomy/methods , Ostomy/statistics & numerical data , Colorectal Neoplasms/surgery , Colonic Neoplasms/surgery , Delivery of Health Care/statistics & numerical data , Colostomy/methods , Colostomy/statistics & numerical data , Ileostomy/methods , Ileostomy/statistics & numerical data , Retrospective Studies , Colorectal Surgery , Middle Aged
9.
Rev. Col. Bras. Cir ; 48: e20212977, 2021. tab
Article in English | LILACS | ID: biblio-1287888

ABSTRACT

ABSTRACT Background: although preservation of bowel continuity is a major goal in rectal cancer surgery, a colorectal anastomosis may be considered an unacceptably high-risk procedure, particularly for patients with multiple comorbidities. We aimed to assess rates of surgical complications in rectal cancer patients according to the type of procedure they had undergone. Materials and Methods: this cohort included all rectal cancer patients undergoing elective resection at a referral academic hospital over 16 years. There were three study groups according to the type of performed operation: (1) rectal resection with anastomosis without defunctioning stoma (DS); (2) rectal resection with anastomosis and DS; and (3) Hartmann's procedure (HP). Postoperative complications and clinical outcomes were assessed. Results: four-hundred and two patients were studied. The 118 patients in group 3 were significantly older (>10 years), had higher Charlson Comorbidity Index scores, and more ASA class ≥3 than patients in the other two groups. Sixty-seven patients (16.7%) had Clavien-Dindo complications grade ≥ III, corresponding to an incidence of 11.8%, 20.9%, and 14.4% in groups 1, 2, and 3, respectively (p=0.10). Twenty-nine patients (7.2%) had major septic complications that required reoperation, with an incidence of 10.8%, 8.2% and 2.5% in groups 1, 2 and 3, respectively (p=0.048). Twenty-one percent of the group 2 patients did not undergo the stoma closure after a 24-month follow-up. Conclusion: HP was associated with a lower incidence of reoperation due to intra-abdominal septic complications. This procedure remains an option for patients in whom serious surgical complications are anticipated.


RESUMO Introdução: embora a preservação do trânsito intestinal seja um dos objetivos principais na cirurgia do câncer retal, a anastomose colorretal pode ser considerada um procedimento de altíssimo risco, particularmente para pacientes com múltiplas comorbidades. Nosso objetivo foi avaliar as taxas de complicações cirúrgicas em pacientes com câncer retal de acordo com o tipo de procedimento a que foram submetidos. Materiais e Métodos: esta coorte incluiu todos os pacientes com câncer retal submetidos a ressecção eletiva em hospital universitário de referência ao longo de 16 anos. Houve três grupos de estudo de acordo com o tipo de operação realizada: (1) ressecção retal com anastomose, sem estoma desfuncionalizante (ED); (2) ressecção retal com anastomose e ED; e (3) procedimento de Hartmann (PH). Avaliamos as complicações pós-operatórias e os resultados clínicos. Resultados: estudamos 402 pacientes. O grupo 3 tinha 118 pacientes, estes sendo significativamente mais idosos (>10 anos), com pontuações mais altas no Índice de Comorbidade de Charlson e mais frequentemente classificados como ASA ≥ 3 do que os pacientes dos outros dois grupos. Sessenta e sete pacientes (16,7%) apresentaram complicações de Clavien-Dindo grau ≥ III, correspondendo à incidência de 11,8%, 20,9% e 14,4% nos grupos 1, 2 e 3, respectivamente (p = 0,10). Vinte e nove pacientes (7,2%) apresentaram complicações sépticas graves, necessitando reoperação, com incidência de 10,8%, 8,2% e 2,5% nos grupos 1, 2 e 3, respectivamente (p = 0,048). Vinte e um por cento dos pacientes do grupo 2 não foram submetidos ao fechamento do estoma após acompanhamento de 24 meses. Conclusão: o PH foi associado à menor incidência de reoperação por complicações sépticas intra-abdominais. Este procedimento continua sendo uma opção para pacientes com alto potencial de desenvolver complicações cirúrgicas graves.


Subject(s)
Humans , Rectal Neoplasms/surgery , Colostomy , Postoperative Complications/surgery , Postoperative Complications/epidemiology , Rectum/surgery , Reoperation , Anastomosis, Surgical , Retrospective Studies , Cohort Studies , Treatment Outcome , Elective Surgical Procedures
10.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1146912

ABSTRACT

Objetivo: analisar a real conjuntura de clientes colostomizados quanto ao conhecimento sobre importância da colostomia, as mudanças ocorridas na sua vida e as dificuldades enfrentadas frente à qualidade de vida. Método: trata-se de uma pesquisa exploratória, descritiva com abordagem qualitativa realizada no Centro Integrado de Saúde referência no estado do Piauí, com 17 clientes que utilizavam bolsa de colostomia. Os dados foram coletados nos meses de março e abril de 2015. Para a análise dos dados, utilizou-se o Discurso do Sujeito Coletivo. Resultados: as pessoas que utilizavam a bolsa de colostomia desenvolveram formas de enfrentamento, dentre essas se destacaram a reflexão, o conhecimento sobre o problema de saúde, o isolamento social e a adaptação. Conclusão: é necessário orientar e fortalecer as estratégias de enfrentamento, pois as mesmas contribuem para diminuir as complicações relacionadas às mudanças físicas e psicológicas do paciente


Objective: to analyze the real situation of colostomized clients in terms of knowledge about the importance of the colostomy, the changes that occurred in their life and the difficulties faced in the quality of life. Method: this is an exploratory, descriptive study with a qualitative approach performed at the Integrated Health Center in the state of Piauí, with 17 clients using a colostomy bag. The data were collected in the months of March and April of 2015. For the analysis of the data, the Discourse of the Collective Subject was used. Results: people who used the colostomy bag developed forms of coping, such as reflection, knowledge about the health problem, social isolation and adaptation. Conclusion: it is necessary to orient and strengthen coping strategies, since they contribute to reduce the complications related to the physical and psychological changes of the patient


Objetivo: analizar la real coyuntura de clientes colostomizados en cuanto al conocimiento sobre la importancia de la colostomía, los cambios ocurridos en su vida y las dificultades enfrentadas frente a la calidad de vida. Método: trata de una investigación exploratoria, descriptiva con abordaje cualitativo realizada en el Centro Integrado de Salud referencia en el estado de Piauí, con 17 clientes que utilizaban bolsa de colostomía. Los datos fueron recolectados en los meses de marzo y abril de 2015. Para el análisis de los datos, se utilizó el Discurso del Sujeto Colectivo. Resultados: las personas que utilizaban la bolsa de colostomía desarrollaron formas de enfrentamiento, entre ellas se destacaron la reflexión, el conocimiento sobre el problema de salud, el aislamiento social y la adaptación. Conclusión: es necesario orientar y fortalecer las estrategias de enfrentamiento, pues las mismas contribuyen a disminuir las complicaciones relacionadas con los cambios físicos y psicológicos del paciente


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Adaptation, Psychological , Colostomy , Colonic Pouches , Quality of Life , Sickness Impact Profile
11.
J. coloproctol. (Rio J., Impr.) ; 40(4): 311-314, Oct.-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1143185

ABSTRACT

ABSTRACT Parastomal Hernia (PSH) is a common complication of patient who undergone ostomy especially end colostomy. Presence of hernia defect is associated with the risk of strangulation and obstruction so understanding the potential risk factor such as patient's factor and technical issues is important. This study is evaluating the incidence of PSH hernia in patients who undergone end colostomy due to Abdominoperineal Resection (APR) in a tertiary colorectal surgery referral center and explore the possible risk factors of this complication. The study was designed as a retrospective cross sectional study on 41 patients who undergone end colostomy due to APR. Three patient lost the follow up and 13 patients died and 25 patients were enrolled in study. Demographic data, history of smoking, steroid administration, Diabetes, obstructive pulmonary disease, transfusion, Neoadjuvant therapy, wound infection and Body mass Index (BMI) were gathered. The mean age of participants was 58.8 and the mean BMI was 25.04 kg/m2. The incidence of PSH was 40% and 68% of operations were done with Laparoscopy. This study could not find statistically significant risk factor for PSH. The 40% incidence of PSH is noticeable and specific strategies should be applied to reduce such complications. Larger studies is essential to investigate the possible etiologies of this complication.


RESUMO A hérnia paraestomal é uma complicação comum em pacientes submetidos a estomia, especialmente a colostomia terminal. A presença de defeito de hérnia está associada ao risco de estrangulamento e obstrução, portanto, é importante compreender o potencial fator de risco, como o fator do paciente e questões técnicas. Este estudo avalia a incidência de hérnia paraestomal em pacientes submetidos à colostomia terminal devido à ressecção abdominoperineal em um centro terciário de referência em cirurgia colorretal e explorar os possíveis fatores de risco dessa complicação. O desenho do estudo foi transversal retrospectivo de 41 pacientes submetidos à colostomia terminal devido à ressecção abdominoperineal. Três pacientes foram perdidos no seguimento, 13 pacientes morreram, e 25 pacientes foram incluídos no estudo. Dados demográficos, história de tabagismo, administração de esteroides, diabetes, doença pulmonar obstrutiva, transfusão, terapia neoadjuvante, infecção de ferida operatória e Índice de Massa Corporal foram coletados. A média de idade dos participantes foi 58,8 e o índice de massa corporal médio foi 25,04 kg/m2. A incidência de hérnia paraestomal foi de 40% e 68% das cirurgias foram realizadas por laparoscopia. Este estudo não encontrou fator de risco estatisticamente significativo para hérnia paraestomal. A incidência de 40% de hérnia paraestomal é perceptível e estratégias específicas devem ser aplicadas para reduzir tais complicações. Estudos maiores são essenciais para investigar as possíveis etiologias dessa complicação.


Subject(s)
Humans , Male , Female , Colostomy/adverse effects , Proctectomy/adverse effects , Hernia/physiopathology
12.
J. coloproctol. (Rio J., Impr.) ; 40(4): 390-393, Oct.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1143181

ABSTRACT

ABSTRACT Pelvic exenteration has showed to be beneficial therapeutically and palliatively in locally advanced colorectal cancer. Reconstruction of urinary transit posterior to a cystectomy has always been challenging with many associated complications. We present a 58-year-old male with locally advanced rectal cancer in which a pelvic exenteration and a double-barreled wet colostomy (DBWC) was created for urinary reconstitution. We present the surgical technique of DBWC. DBWC is a good alternative to other urinary reconstructions because fecal and urinary derivation occurs in only one stoma, the stoma output is easier to manage, and fewer complications are seen compared to other urinary reconstructions. Long-term surveillance is mandatory in patients with a DBWC because there is an increased risk of neoplasm in the reservoir.


RESUMO A exenteração pélvica mostrou-se benéfica, tanto terapêutica quanto paliativamente, em casos de câncer colorretal localmente avançado. A reconstrução do trânsito urinário após uma cistectomia sempre foi desafiadora, com muitas complicações associadas. Os autores apresentam o caso de um homem de 58 anos de idade com câncer retal localmente avançado, submetido a uma exenteração pélvica e uma colostomia úmida em dupla-boca (CUDB) para reconstituição urinária. Os autores apresentam a técnica cirúrgica da CUDB, uma boa alternativa para outras reconstruções urinárias, já que a derivação fecal e urinária ocorre em apenas um estoma, a saída do estoma é mais fácil de gerenciar e o método apresenta menos complicações em comparação com outras reconstruções urinárias. A vigilância a longo prazo é obrigatória em pacientes com CUDB, pois há um risco aumentado de neoplasia no reservatório.


Subject(s)
Humans , Male , Middle Aged , Pelvic Exenteration/statistics & numerical data , Colostomy/statistics & numerical data , Colorectal Neoplasms/surgery
13.
J. coloproctol. (Rio J., Impr.) ; 40(3): 269-272, July-Sept. 2020. ilus
Article in English | LILACS | ID: biblio-1134998

ABSTRACT

Abstract Introduction: The Coronavirus belongs to a family of RNA viruses that can cause respiratory infection, with the possibility of gastrointestinal manifestations in approximately 5-50% of the cases. Objective: To report a surgical case with a diagnosis of COVID-19 that developed acute perforated abdomen and pneumothorax. Case report: This was an 80-year-old female patient with respiratory symptoms, with dry cough and fever and diffuse abdominal pain with signs of peritonitis. She had leukocytosis, kidney dysfunction and an increase in D-dimer with positive PCR for COVID. Computed tomography of the chest and abdomen showed pneumothorax on the right and extensive pneumoperitoneum. Conclusion: The presentation of COVID-19 with severe pulmonary and abdominal complications requires specialized and emergency treatments, but it has high mortality rates.


Resumo Introdução: O coronavírus pertence a uma família de vírus RNA que pode causar infecção respiratória com possibilidade de manifestações gastrintestinais em torno de 5% a 50% dos casos. Objetivo: Relatar caso operado com diagnóstico de COVID-19 e evolução com abdome agudo perfurativo e pneumotórax. Relato do caso: Paciente do sexo feminino de 80 anos com sintomas respiratórios com tosse seca e febre e dor abdominal difusa com sinais de peritonite. Apresentava leucocitose, disfunção renal e aumento de D-dímero com PCR positivo para COVID. Tomografia computadorizada de tórax e abdome demonstrando pneumotórax à direita e extenso pneumoperitônio. Conclusão: A apresentação do COVID-19 com sérias complicações pulmonar e abdominal requer tratamentos especializados e em regime de emergência, entretanto com altas taxas de mortalidade.


Subject(s)
Humans , Female , COVID-19/complications , Abdomen, Acute , Pneumoperitoneum , Pneumothorax , Colostomy
14.
Rev. cir. (Impr.) ; 72(4): 347-349, ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1138721

ABSTRACT

Resumen Introducción: Los hongos dematiáceos se caracterizan por la presencia de abundante melanina en su pared celular. Presentan una distribución mundial, siendo más comunes en climas tropicales y subtropicales. Producen infecciones cutáneas y subcutáneas, además de enfermedades alérgicas, neumonías, abscesos cerebrales o infecciones diseminadas. Caso Clínico: Presentamos el caso de un paciente con adenocarcinoma de recto intervenido quirúrgicamente con hallazgo incidental de divertículo de Meckel y en el cual en el estudio anatomopatológico reveló la presencia de un hongo dematiáceo


Introduction: Dematiaceous fungi are characterized by the presence of brown melanine or melanine like pigments in their cell wall. They are generally distributed worldwide, being more common in tropical and subtropical climates. The clinical syndromes are often cutaneous and subcutaneous infections, but can be also responsible of allergic diseases, pneumonias, cerebral abscesses or disseminated infections. Clinical Case: We present the case of a patient with a diagnosis of rectal adenocarcinoma intervening surgically and with an incidental finding of Meckel's Diverticulum. The anatomopathological study revealed the presence of a dematiaceous fungi.


Subject(s)
Humans , Male , Aged , Diverticulitis/surgery , Alternaria/pathogenicity , Meckel Diverticulum/surgery , Colostomy/methods
15.
J. coloproctol. (Rio J., Impr.) ; 40(1): 61-66, Jan.-Mar. 2020. tab, ilus
Article in English | LILACS | ID: biblio-1090837

ABSTRACT

Abstract Rationale: Disuse colitis is frequent in our country and the most effective treatment is high cost and there is a need for effective and low cost therapy. Objective: To evaluate the efficacy of Baccharis dracunculifolia (field rosemary) in the treatment of exclusion colitis in rats. Method: Eighteen Wistar rats were anesthetized and submitted to colostomy; they were then distributed into two groups: Control Group, receiving intrarectal saline infusion (n = 8) and Group BD receiving intrarectal infusion ofBaccharis dracunculifolia extract (n = 10); after 21 days of treatment they were euthanized, the intestinal segment excluded from intestinal transit was resected and submitted to histopathological study, classifying the degree of inflammation and degree of vascular congestion from 0 to 3. Results: Mean inflammation was 2.7 in Control Group versus 2.1 in BD Group (p = 0.049), while mean vascular congestion was 2.3 and 2, respectively, in Control and BD groups (p = 0.1642). Conclusion: Intra-rectal infusion ofBaccharis dracunculifolia extract significantly minimized the inflammatory process in the exclusion colitis of rats submitted to colostomy, without altering the degree of vascular congestion.


Resumo Racional A colite de desuso é frequente em nosso meio e o tratamento de maior eficácia é de alto custo, havendo necessidade de se encontrar uma terapêutica eficaz e de baixo custo. Objetivo Avaliar a eficácia da Baccharis dracunculifolia (alecrim-do-campo) no tratamento da colite de exclusão em ratos. Método Utilizou-se 18 ratos Wistar, os quais foram anestesiados e submetidos à colostomia; em seguida distribuídos em 2 grupos: Grupo Controle, recebendo infusão intrarretal de solução salina (n = 8) e Grupo BD, recebendo infusão intrarretal de extrato de Baccharis dracunculifolia (n = 10); após 21 dias de tratamento foram submetidos a eutanásia, o segmento intesinal excluso de trânsito intestinal foi ressecado e submetido a estudo histopatológico classificando-se o grau de inflamação e grau de congestão vascular de 0 a 3. Resultados Verificou-se média de inflamação 2,7 no Grupo Controle vs. 2,1 no Grupo BD (p = 0,049), enquanto as médias de congestão vascular foram 2,3 e 2, respectivamente, nos grupos controle e BD (p = 0,1642). Conclusão A infusão intrarretal do extrato de Baccharis dracunculifolia minimizou significantemente o processo inflamatório na colite de exclusão de ratos submetidos à colostomia, sem alterar o grau de congestão vascular.


Subject(s)
Animals , Rats , Colitis , Colitis/drug therapy , Plant Preparations , Vernonia , Phytotherapy , Plants, Medicinal , Colostomy , Vernonia/adverse effects
16.
Rev. enferm. UFPI ; 9: e8979, mar.-dez. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1369739

ABSTRACT

Objetivo: caracterizar a clientela com estomas intestinais de eliminação em hospital privado de capital brasileira. Metodologia: estudo descritivo, retrospectivo, transversal e analítico. Os dados foram coletados em prontuários eletrônicos. Trinta pessoas compuseram a amostra. As variáveis contínuas foram analisadas na forma descritiva. As variáveis categóricas foram apresentadas como frequências absolutas e relativas. Para as variáveis "idade" e "dias de internação" foi calculada a correlação de Pearson. Resultados: a maioria das pessoas com estomas intestinais internadas era do sexo masculino (53,0%), média de idade de 59 anos, casada (63,0%), ativa no mercado de trabalho (86,0%), procedente de cidades do interior do estado, tendo o câncer colorretal como doença de base (88,0%), metade portadora de ileostomia e a outra metade de colostomia. Conclusão: o estudo possibilitou caracterizar a clientela em questão. Contribuiu com dados que favoreçam a sistematização da assistência de enfermagem. Houve como limitante a falta de registro da escolaridade de vários pacientes.


Objective: to characterize the clients with intestinal elimination stomas in a private hospital of Brazilian capital. Methodology: it is a descriptive, retrospective, transversal and analytical study. The data were collected in electronic medical records, with 30 people composing the sample. Continuous variables were analyzed descriptively. Categorical variables are presented as absolute and relative frequencies. For the variables "age" and "days of hospitalization" Pearson's correlation was calculated. Results: the majority of people hospitalized with intestinal stomas were male (53.0%), mean age 59 years, married (63.0%), active in the labor market (86.0%), colorectal cancer as baseline disease (88.0%), with half being ileostomy and the other half colostomy. Conclusion: the study made it possible to characterize the clientele in question and will contribute with data that favor the systematization of nursing care. There was a limitation of the lack of registration of the education of several patients.


Subject(s)
Health Profile , Colostomy , Ileostomy , Nursing
17.
Int. braz. j. urol ; 46(1): 108-115, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056353

ABSTRACT

ABSTRACT Objective: Cystectomy with urinary diversion is the gold standard for muscle invasive bladder cancer. It also may be performed as part of pelvic exenteration for non-urologic malignancy, neurogenic bladder dysfunction, and chronic conditions that result in a non-functional bladder (e.g., interstitial cystitis, radiation cystitis). Our objective is to describe the surgical technique of urinary diversion using large intestine as a conduit whilst creating an end colostomy, thereby avoiding a primary bowel anastomosis and to show its applicability with respect to urologic conditions. Materials and Methods: We retrospectively reviewed five cases from a single institution that utilized the described method of urinary diversion with large intestine. We describe operative times, hospital length of stay (LOS), and describe post-operative complications. Results: Five patients with a variety of urologic and oncologic pathology underwent the described procedures. Their operative times ranged from 5 hours to 11 hours and one patient experienced a Clavien III complication. Conclusion: We describe five patients who underwent this procedure for various medical indications, and describe their outcomes, and believe dual diversion of urinary and gastrointestinal systems with colon as a urinary conduit to be an excellent surgical option for the appropriate surgical candidate.


Subject(s)
Humans , Male , Adult , Colon, Sigmoid/surgery , Colostomy/methods , Urinary Diversion/methods , Urinary Bladder Diseases/surgery , Anastomosis, Surgical , Cystectomy/methods , Reproducibility of Results , Treatment Outcome , Operative Time , Length of Stay , Medical Illustration , Middle Aged
18.
Clinics ; 75: e2046, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133364

ABSTRACT

The use of colorectal self-expanding metal stents (SEMS) as bridge therapy for malignant colorectal obstruction was first reported more than 20 years ago. However, its use remains controversial. Objective: In this study, we aimed to compare the long-term survival of patients with potentially resectable malignant colorectal obstruction who had undergone colorectal SEMS placement and emergency surgery. Methods: This study was a retrospective analyses. Patients who received treatment between 2009 and 2017 were included. According to the eligibility criteria, 21 patients were included in the SEMS group and 67 patients were included in the surgical group.. Results: The majority of the patients in the SEMS group were female (57.1%), whereas the majority of those in the surgical group were male (53.7%). The median follow-up time was 60 months for both groups with the same interquartile range of 60 months. There was no difference in the overall survival rate (log rank p=0.873) and disease-free survival rate (log rank p=0.2821) in the five-year analysis. There was no difference in local recurrence rates (38.1% vs. 22.4%, p=0.14) or distant recurrence rates (33.3% vs. 50.7%, p=0.16) in the SEMS and the surgical groups. Technical and clinical success rates of endoscopic stenting were 95.3% and 85.7%, respectively. There were no immediate adverse events (AEs). Severe AEs included perforation (14.3%), silent perforation (4.7%), reobstruction (14.3%), and bleeding (14.3%). Mild AEs included pain (42.8%), tenesmus (9.5%), and incontinence (4.76%). The limitations of this study was retrospective and was conducted at a single center. Conclusions: No differences in disease-free and overall survival rates were observed in the five-year analysis of patients with resectable colorectal cancer who had undergone SEMS placement or colostomy for the treatment of malignant colorectal obstruction. Patients in the SEMS group had a higher rate of primary anastomosis and a lower rate of temporary colostomy than did those in the surgery group.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/surgery , Colorectal Neoplasms/complications , Intestinal Obstruction/surgery , Intestinal Obstruction/etiology , Colostomy , Stents , Retrospective Studies , Treatment Outcome , Neoplasm Recurrence, Local
19.
Clinics ; 75: e1353, 2020. tab, graf
Article in English | LILACS | ID: biblio-1055877

ABSTRACT

OBJECTIVE: Stoma prolapse is an intussusception of the bowel through a mature stoma. It can be caused by increased intra-abdominal pressure, excessively mobile bowel mesentery and/or a large opening in the abdominal wall at the time of stoma formation. It occurs predominantly in loop stomas, and correction methods include conservative modalities, such as local reduction to the prolapsed bowel, or surgical treatment. The purpose of this study was to describe our experience with the treatment of colostomy prolapse using a novel mesh strip technique. METHODS: Between February 2009 and March 2018, ten consecutive male patients underwent correction of colostomy prolapse under local anesthesia by peristomal placement of a polypropylene mesh strip. Operation time, short- and long-term complications, and recurrence rates were recorded and analyzed. RESULTS: No postoperative complications, morbidity or mortality were observed. The median length of the prolapse ranged from 6-20 cm, and the median operative time was 30 minutes. The median duration of follow-up was 25 months (range, 12-89 months). No relapse, mesh strip extrusion, local infection or granuloma formation were found. CONCLUSION: A simple, fast, and low-cost operation under local anesthesia using a mesh strip is a valuable option to treat colostomy prolapse.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Postoperative Complications/surgery , Surgical Mesh , Colostomy/rehabilitation , Colonic Diseases/surgery , Surgical Stomas/adverse effects , Prolapse , Treatment Outcome , Abdominal Wall
20.
ABCD arq. bras. cir. dig ; 33(3): e1546, 2020. tab, graf
Article in English | LILACS | ID: biblio-1152618

ABSTRACT

ABSTRACT Background: The Hartmann procedure remains the treatment of choice for most surgeons for the urgent surgical treatment of perforated diverticulitis; however, it is associated with high rates of ostomy non-reversion and postoperative morbidity. Aim: To study the results after the Hartmann vs. resection with primary anastomosis, with or without ileostomy, for the treatment of perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV), and to compare the advantages between the two forms of treatment. Method: Systematic search in the literature of observational and randomized articles comparing resection with primary anastomosis vs. Hartmann's procedure in the emergency treatment of perforated diverticulitis. Analyze as primary outcomes the mortality after the emergency operation and the general morbidity after it. As secondary outcomes, severe morbidity after emergency surgery, rates of non-reversion of the ostomy, general and severe morbidity after reversion. Results: There were no significant differences between surgical procedures for mortality, general morbidity and severe morbidity. However, the differences were statistically significant, favoring primary anastomosis in comparison with the Hartmann procedure in the outcome rates of stoma non-reversion, general morbidity and severe morbidity after reversion. Conclusion: Primary anastomosis is a good alternative to the Hartmann procedure, with no increase in mortality and morbidity, and with better results in the operation for intestinal transit reconstruction.


RESUMO Racional: O procedimento a Hartmann permanece sendo o tratamento de escolha da maioria dos cirurgiões para o tratamento cirúrgico de urgência da diverticulite perfurada, entretanto está associado com altas taxas de não reversão da ostomia e de morbidade pós-operatória. Objetivo: Estudar os resultados após o procedimento de Hartmann vs. ressecção com anastomose primária, com ou sem ileostomia, para o tratamento da diverticulite perfurada com peritonite purulenta ou fecal (grau de Hinchey III ou IV), e comparar as vantagens entre as duas formas de tratamento. Método: Busca sistemática na literatura de artigos observacionais e randomizados comparando ressecção com anastomose primária vs. procedimento de Hartmann no tratamento de urgência da diverticulite perfurada. Analisar como desfechos primários a mortalidade após a operação de urgência e a morbidade geral após ela; como desfechos secundários, a morbidade severa após a operação de urgência, as taxas de não reversão da ostomia, a morbidade geral e severa após a reversão. Resultados: Não houve diferenças significativas entre os procedimentos cirúrgicos para mortalidade, morbidade geral e morbidade severa. Contudo, as diferenças foram significativas estatisticamente favorecendo anastomose primária na comparação com procedimento de Hartmann nos desfechos taxas de não reversão do estoma, morbidade geral e morbidade severa após reversão. Conclusão: A anastomose primária apresenta-se como boa alternativa ao procedimento de Hartmann, sem aumento de mortalidade e morbidade, e com melhores resultados na operação de reconstrução do trânsito intestinal.


Subject(s)
Humans , Peritonitis/etiology , Colon, Sigmoid/surgery , Digestive System Surgical Procedures/adverse effects , Diverticulitis/surgery , Diverticulitis/complications , Intestinal Perforation/surgery , Peritonitis/surgery , Postoperative Complications , Digestive System Surgical Procedures/methods , Anastomosis, Surgical/methods , Colostomy/adverse effects , Ileostomy/adverse effects , Treatment Outcome , Diverticulitis/pathology , Intestinal Perforation/pathology
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