ABSTRACT
AIM: Stoma formation is believed to have a more significant effect on quality of life in Asian patients than in non-Asian patients, but this has never been formally demonstrated. This study examined factors which may influence quality of life following stoma formation with particular reference to ethnicity. METHOD: Quality of life was measured (using an established questionnaire) in consecutive patients undergoing stoma formation under the care of two colorectal surgeons. RESULTS: Quality of life is poorer in Asian than in non-Asian patients 46 ± 13 vs 60 ± 12 (P = 0.007). This difference is restricted to those born outside the UK and to those who cannot speak English (P = 0.0008 and P = 0.0001, respectively). CONCLUSION: The association between stoma formation and poor quality of life in Asian patients is more complicated than previously assumed. Selected patient groups can be targeted with information and support.
Subject(s)
Asian People/psychology , Colostomy/psychology , Culture , Ileostomy/psychology , Quality of Life/psychology , Emigrants and Immigrants/psychology , Female , Humans , Language , Male , Preoperative Care , Surveys and QuestionnairesABSTRACT
BACKGROUND: Laparoscopic live donor nephrectomy (LDN) has become established as a safe and effective alternative to the open procedure. However, the effect of prolonged warm ischemia time (WIT) during retrieval of the kidney remains unclear. The aim of this study was to analyze the effects of WIT on short-term and long-term graft outcomes after LDN. METHOD: In this retrospective analysis of LDN the effects of WIT on delayed graft function, rate of decline in serum creatinine concentration (SCr) in the first 10 days, changes in SCr at 3 months, acute rejection rate changes in Delta creatinine, biopsy-proved chronic allograft rejection and graft survival were assessed according to duration of WIT. Analysis was made by comparing WIT < or =3 versus >3 minutes and WIT <5, 5-10, and >10 minutes. RESULTS: The WIT, which ranged from 1 to 15 minutes, appeared to be related to the learning curve and to technical difficulties. Prolonged WIT did not appear to have an effect on early graft function or the rate of decline in SCr during the first 3 months posttransplantation, but may be associated with an increased rate of acute rejection. Changes in Delta creatinine over time were not affected by the length of WIT during LDN. CONCLUSION: WIT encountered during LDN has no effect on either short-term or long-term graft outcome.
