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Canadian enterostomal therapy nurses advancing wound, ostomy and continence nursing.

https://arctichealth.org/en/permalink/ahliterature124527
Source
J Wound Ostomy Continence Nurs. 2012 May-Jun;39(3):240-2
Publication Type
Article
Author
Nancy Parslow
Janet Kuhnke
Kathryn Kozell
Author Affiliation
Enterostomal and Wound Care, University Health Network, Toronto, Canada.
Source
J Wound Ostomy Continence Nurs. 2012 May-Jun;39(3):240-2
Language
English
Publication Type
Article
Keywords
Canada
Enterostomy - nursing
Fecal Incontinence - nursing
Humans
Nurse's Role
Specialties, Nursing - standards
Surgical Stomas
Total Quality Management
Urinary Incontinence - nursing
Wounds and Injuries - nursing
PubMed ID
22572895 View in PubMed
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Cost effectiveness of mesh prophylaxis to prevent parastomal hernia in patients undergoing permanent colostomy for rectal cancer.

https://arctichealth.org/en/permalink/ahliterature106255
Source
J Am Coll Surg. 2014 Jan;218(1):82-91
Publication Type
Article
Date
Jan-2014
Author
Lawrence Lee
Abdulaziz Saleem
Tara Landry
Eric Latimer
Prosanto Chaudhury
Liane S Feldman
Author Affiliation
Steinberg-Bernstein Centre for Minimally-Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada; Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Source
J Am Coll Surg. 2014 Jan;218(1):82-91
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Canada
Colostomy - economics - instrumentation - methods
Cost-Benefit Analysis
Health Care Costs - statistics & numerical data
Hernia, Ventral - economics - etiology - prevention & control
Humans
Markov Chains
Middle Aged
Models, Economic
Neoplasm Staging
Postoperative Complications - economics - prevention & control
Quality-Adjusted Life Years
Rectal Neoplasms - pathology - surgery
Surgical Mesh - economics
Surgical Stomas
Abstract
Parastomal hernia (PSH) is common after stoma formation. Studies have reported that mesh prophylaxis reduces PSH, but there are no cost-effectiveness data. Our objective was to determine the cost effectiveness of mesh prophylaxis vs no prophylaxis to prevent PSH in patients undergoing abdominoperineal resection with permanent colostomy for rectal cancer.
Using a cohort Markov model, we modeled the costs and effectiveness of mesh prophylaxis vs no prophylaxis at the index operation in a cohort of 60-year-old patients undergoing abdominoperineal resection for rectal cancer during a time horizon of 5 years. Costs were expressed in 2012 Canadian dollars (CAD$) and effectiveness in quality-adjusted life years. Deterministic and probabilistic sensitivity analyses were performed.
In patients with stage I to III rectal cancer, prophylactic mesh was dominant (less costly and more effective) compared with no mesh. In patients with stage IV disease, mesh prophylaxis was associated with higher cost (CAD$495 more) and minimally increased effectiveness (0.05 additional quality-adjusted life years), resulting in an incremental cost-effectiveness ratio of CAD$10,818 per quality-adjusted life year. On sensitivity analyses, the decision was sensitive to the probability of mesh infection and the cost of the mesh, and method of diagnosing PSH.
In patients undergoing abdominoperineal resection with permanent colostomy for rectal cancer, mesh prophylaxis might be the less costly and more effective strategy compared with no mesh to prevent PSH in patients with stage I to III disease, and might be cost effective in patients with stage IV disease.
PubMed ID
24210147 View in PubMed
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Current use of diverting stoma in anterior resection for cancer: population-based cohort study of total and partial mesorectal excision.

https://arctichealth.org/en/permalink/ahliterature278444
Source
Int J Colorectal Dis. 2016 Mar;31(3):579-85
Publication Type
Article
Date
Mar-2016
Author
Martin Rutegård
Petrus Boström
Markku Haapamäki
Peter Matthiessen
Jörgen Rutegård
Source
Int J Colorectal Dis. 2016 Mar;31(3):579-85
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Aged
Anastomosis, Surgical
Cohort Studies
Demography
Digestive System Surgical Procedures
Humans
Logistic Models
Multivariate Analysis
Rectal Neoplasms - surgery
Risk factors
Surgical Stomas - pathology
Sweden
Time Factors
Abstract
A diverting stoma is commonly used to reduce the risk of anastomotic leakage when performing total mesorectal excision (TME) in anterior resection for rectal cancer. The purpose of this study was to evaluate the impact of fecal diversion in relation to partial mesorectal excision (PME).
A retrospective analysis was undertaken on a national cohort, originally created to study the impact of central arterial ligation on patients with increased cardiovascular risk. Some 741 patients operated with anterior resection for rectal cancer during the years 2007 through 2010 were followed up for 53 months. Multivariate logistic regression was used to evaluate the impact of diverting stoma on the risk of anastomotic leakage and permanent stoma, expressed as odds ratios (ORs) and 95% confidence intervals (CIs).
The risk of anastomotic leakage was increased in TME surgery when not using a diverting stoma (OR 5.1; 95% CI 2.2-11.6), while the corresponding risk increase in PME patients was modest (OR 1.8; 95% CI 0.8-4.0). At study completion or death, 26 and 13% of TME and PME patients, respectively, had a permanent stoma. A diverting stoma was a statistically significant risk factor for a permanent stoma in PME patients (OR 4.7; 95% CI 2.5-9.0), while less important in TME patients (OR 1.8; 95% CI 0.6-5.5).
The benefit of a diverting stoma concerning anastomotic leakage in this patient group seems doubtful. Moreover, the diverting stoma itself may contribute to the high rate of permanent stomas.
PubMed ID
26670673 View in PubMed
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Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy.

https://arctichealth.org/en/permalink/ahliterature172453
Source
Health Qual Life Outcomes. 2005;3:62
Publication Type
Article
Date
2005
Author
Luis Prieto
Hanne Thorsen
Kristian Juul
Author Affiliation
prietol@vodafone.es
Source
Health Qual Life Outcomes. 2005;3:62
Date
2005
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Colon - surgery
Colostomy - psychology
Denmark
Female
France
Great Britain
Humans
Ileostomy - psychology
Ileum - surgery
Interpersonal Relations
Male
Middle Aged
Models, Psychological
Psychometrics - instrumentation
Quality of Life
Questionnaires
Self Concept
Spain
Surgical Stomas
Translations
Abstract
Quality of life of stoma patients is increasingly being addressed in clinical trials. However, the instruments used in the majority of these studies have not been validated specifically for stoma patients. The aim of this paper is to describe the development and validation of a quality-of-life instrument, "Stoma-QOL", specifically for patients with colostomy or ileostomy.
Potential items were formulated in English on the basis of the results of a series of semi-structured interviews with 169 adult stoma patients. The process resulted in a preliminary 37-item version, which was translated into French, German, Spanish and Danish, and administered repeatedly to 182 patients with colostomy or ileostomy. A psychometric selection of items was performed through Rasch Analysis. The measurement properties of the final questionnaire version were subsequently tested.
The 20 items in the final questionnaire covered four domains--sleep, sexual activity, relations to family and close friends, and social relations to other than family and close friends. These items were found to define a unidimensional variable according to Rasch specifications (Infit MNSQ 0.88 (p
Notes
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PubMed ID
16219109 View in PubMed
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Elicitation of ostomy pouch preferences: a discrete-choice experiment.

https://arctichealth.org/en/permalink/ahliterature132892
Source
Patient. 2011;4(3):163-75
Publication Type
Article
Date
2011
Author
Ole Bonnichsen
Author Affiliation
Institute of Food and Resource Economics, Faculty of Life Sciences, University of Copenhagen, Denmark. ole@foi.dk
Source
Patient. 2011;4(3):163-75
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chi-Square Distribution
Choice Behavior
Female
Humans
Male
Middle Aged
Models, Statistical
Patient Preference
Quality of Life
Questionnaires
Surgical Stomas
Sweden
Abstract
Previous studies about patients who have undergone ostomy surgery commonly address the issues of the surgery, complications, preoperative counseling, quality of life, and psychosocial changes following surgery. Only a limited number of studies deal with how technical improvements in stoma care would affect patients and, to the author's knowledge, the present study is the first to elicit preferences for potential improvements in ostomy pouches in the form of monetary values.
This article examines and measures Swedish patients' preferences for potential improvements in ostomy pouch attributes. The theory, study design, elicitation procedure, and resulting preference structure of the sample is described.
A discrete-choice experiment (DCE) was used to elicit preferences. Respondents were asked to choose between alternatives in choice sets, in which each alternative comprised a number of attributes relating to the adhesive, filter, and flexibility of ostomy pouches. The choices between alternatives made by the respondent imply a trade-off between the attributes and allow for the estimation of individuals' willingness to pay (WTP) for the attributes of ostomy pouches when cost is included as an attribute. A total of 254 patients responded to the survey and preferences were estimated using a random parameter logit econometric specification.
Respondents had significantly positive WTP for all potential attribute improvements presented in the survey, with the strongest preference for reducing the number of leakages; flexibility of the system weighted second, and filter lifetime was the least important.
The results confirm that the potential attribute improvements presented to the respondents in this study significantly and positively affect the utility that patients would obtain from a potential improvement in their ostomy pouch. This provides information as to how treatment options in terms of stoma management can be structured so as to maximize the benefits for patients.
PubMed ID
21766912 View in PubMed
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Enterostomal therapy nursing in the Canadian home care sector: what is its value?

https://arctichealth.org/en/permalink/ahliterature146070
Source
J Wound Ostomy Continence Nurs. 2010 Jan-Feb;37(1):53-64
Publication Type
Article
Author
Linda Baich
Donna Wilson
Greta G Cummings
Author Affiliation
Red Deer College, Red Deer, Alberta, Canada. lbaich@ualberta.ca
Source
J Wound Ostomy Continence Nurs. 2010 Jan-Feb;37(1):53-64
Language
English
Publication Type
Article
Keywords
Canada
Enterostomy - nursing
Home Care Services
Humans
Outcome Assessment (Health Care)
Reproducibility of Results
Surgical Stomas
Abstract
Approximately one-third of all home care patients have wound care needs. Home care patients tend to be older and have multiple chronic diseases rendering them at risk for developing wounds and impairing their ability to heal wounds. Enterostomal therapy (ET) nurses have expertise in wound, ostomy, and continence care, and were recently recognized by the Canadian Nurses Association as a specialty practice. We completed a systematic review in order to identify and synthesize evidence about the value of ET nurses in the Canadian home care sector, focusing on wound care. A literature search was conducted, using 9 computerized library databases. Eight articles were identified for review; each was analyzed using qualitative content analysis. Two themes emerged from our analysis: (1) assessing the outcomes of ET nurse involvement in client care and (2) methods for using ET nurses' expertise. Within these themes, the benefits of ET nurses working in home care were identified: (1) a decreased number of visits, (2) reduced wound-healing times, (3) successful healing, (4) reduced cost of wound care, (5) greater support for nurses and families, (6) fewer emergency department visits, (7) fewer hospital readmissions, (8) increased interest in education in wound care among other nurses, and (9) standardized protocols for wound care. Although only 8 studies were located for this review, their findings provide evidence that ET nurses' contributions to wound care are not only positive but also necessary in the home care sector.
PubMed ID
20075693 View in PubMed
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Establishment of a regional Danish database for patients with a stoma.

https://arctichealth.org/en/permalink/ahliterature266068
Source
Colorectal Dis. 2015 Jan;17(1):O27-33
Publication Type
Article
Date
Jan-2015
Author
A K Danielsen
B M Christensen
J. Mortensen
L L Voergaard
P. Herlufsen
L. Balleby
Source
Colorectal Dis. 2015 Jan;17(1):O27-33
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Databases, Factual - statistics & numerical data
Denmark
Enterostomy - methods - statistics & numerical data
Female
Humans
Male
Surgical Stomas - statistics & numerical data
Urologic Surgical Procedures - methods - statistics & numerical data
Abstract
To present the Danish Stoma Database Capital Region with clinical variables related to stoma creation including colostomy, ileostomy and urostomy.
The stomatherapists in the Capital Region of Denmark developed a database covering patient identifiers, interventions, conditions, short-term outcome, long-term outcome and known major confounders. The completeness of data was validated against the Danish National Patient Register.
In 2013, five hospitals included data from 1123 patients who were registered during the year. The types of stomas formed from 2007 to 2013 showed a variation reflecting the subspecialization and surgical techniques in the centres. Between 92 and 94% of patients agreed to participate in the standard programme aimed at handling of the stoma and more than 88% of patients having planned surgery had the stoma site marked pre-operatively.
The database is fully operational with high data completeness and with data about patients with a stoma from before surgery up to 12 months after surgery. The database provides a solid basis for professional learning, clinical research and benchmarking.
PubMed ID
25418604 View in PubMed
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High stoma prevalence and stoma reversal complications following anterior resection for rectal cancer: a population-based multicentre study.

https://arctichealth.org/en/permalink/ahliterature294215
Source
Colorectal Dis. 2017 Dec; 19(12):1067-1075
Publication Type
Evaluation Studies
Journal Article
Multicenter Study
Date
Dec-2017
Author
K Holmgren
D Kverneng Hultberg
M M Haapamäki
P Matthiessen
J Rutegård
M Rutegård
Author Affiliation
Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
Source
Colorectal Dis. 2017 Dec; 19(12):1067-1075
Date
Dec-2017
Language
English
Publication Type
Evaluation Studies
Journal Article
Multicenter Study
Keywords
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Anastomotic Leak - epidemiology - etiology
Female
Humans
Logistic Models
Male
Middle Aged
Neoplasm Staging
Prevalence
Proportional Hazards Models
Rectal Neoplasms - pathology - surgery
Rectum - surgery
Registries
Reoperation - adverse effects - methods
Retrospective Studies
Risk factors
Surgical Stomas - adverse effects
Sweden - epidemiology
Treatment Outcome
Abstract
Fashioning a defunctioning stoma is common when performing an anterior resection for rectal cancer in order to avoid and mitigate the consequences of an anastomotic leakage. We investigated the permanent stoma prevalence, factors influencing stoma outcome and complication rates following stoma reversal surgery.
Patients who had undergone an anterior resection for rectal cancer between 2007 and 2013 in the northern healthcare region were identified using the Swedish Colorectal Cancer Registry and were followed until the end of 2014 regarding stoma outcome. Data were retrieved by a review of medical records. Multiple logistic regression was used to evaluate predefined risk factors for stoma permanence. Risk factors for non-reversal of a defunctioning stoma were also analysed, using Cox proportional-hazards regression.
A total of 316 patients who underwent anterior resection were included, of whom 274 (87%) were defunctioned primarily. At the end of the follow-up period 24% had a permanent stoma, and 9% of patients who underwent reversal of a stoma experienced major complications requiring a return to theatre, need for intensive care or mortality. Anastomotic leakage and tumour Stage IV were significant risk factors for stoma permanence. In this series, partial mesorectal excision correlated with a stoma-free outcome. Non-reversal was considerably more prevalent among patients with leakage and Stage IV; Stage III patients at first had a decreased reversal rate, which increased after the initial year of surgery.
Stoma permanence is common after anterior resection, while anastomotic leakage and advanced tumour stage decrease the chances of a stoma-free outcome. Stoma reversal surgery entails a significant risk of major complications.
Notes
CommentIn: Colorectal Dis. 2018 Apr;20(4):342 PMID 29327402
CommentIn: Colorectal Dis. 2018 Apr;20(4):342-343 PMID 29377501
PubMed ID
28612478 View in PubMed
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[Incidence, cause and treatment of colonic perforations in Iceland 1998-2007: A nationwide study].

https://arctichealth.org/en/permalink/ahliterature283433
Source
Laeknabladid. 2017 Februar;103(2):73-77
Publication Type
Article
Author
Kristin Jonsdottir
Elsa B Valsdottir
Shreekrishna Datye
Fritz Berndsen
Pall Helgi Moller
Source
Laeknabladid. 2017 Februar;103(2):73-77
Language
Icelandic
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Colonic Diseases - diagnosis - epidemiology - mortality - surgery
Databases, Factual
Digestive System Surgical Procedures - adverse effects - mortality
Female
Humans
Iceland - epidemiology
Incidence
Intestinal Perforation - diagnosis - epidemiology - mortality - surgery
Male
Middle Aged
Retrospective Studies
Risk factors
Surgical Stomas - adverse effects
Time Factors
Treatment Outcome
Abstract
Colon perforation is a serious illness with mortality reported from 0-39%. Surgery used to be the gold standard but treatment has changed as studies have indicated comparable results with less invasive treatment. The aim of this study was to evaluate the incidence of acute colon perforations in Iceland, causes and treatment.
A retrospective, nationwide, multicenter analysis was performed based on ICD-10 codes from databases of the main hospitals in Iceland. Age, gender, year of perforation, cause, means of diagnosis, treatment and outcome were registered. Patients under 18 years and post mortem diagnosis were excluded.
225 patients met criteria, 131 women (58%) and 94 men (42%), median age 70 years (range 30-95). The most common causes were diverticulitis (67%), colonoscopy (12%) and complications during operations (5%). During the first five study years, 27% received conservative treatment while 71% underwent surgery. By the end of the study era this ratio was 45% and 54% respectively. The rate of permanent stoma was 10%.
Diverticulitis was the most common cause of colon perforation in Iceland during the study period. Many patients still undergo surgery but there has been a dramatic change toward more conservative treatment. The rate of stoma closure is comparable to studies elsewhere. 1University Hospital of Iceland, Dept. General Surgery, 2University of Iceland, Faculty of Medicine, 3Akureyri Teaching Hospital, 4Akranes Hospital and Health Care Center, Iceland. Key words: Colon perforation, diverticulitis, Hartmann's reversal. Correspondence: Elsa B. Valsdottir, elsava@landspitali.is.
PubMed ID
28489013 View in PubMed
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Late side effects and quality of life after radiotherapy for rectal cancer.

https://arctichealth.org/en/permalink/ahliterature98987
Source
Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1005-11
Publication Type
Article
Date
Mar-15-2010
Author
Kjersti Bruheim
Marianne G Guren
Eva Skovlund
Marianne J Hjermstad
Olav Dahl
Gunilla Frykholm
Erik Carlsen
Kjell Magne Tveit
Author Affiliation
The Cancer Centre, Oslo University Hospital, Ullevål, 0407 Oslo, Norway. Kjersti.Bruheim@medisin.uio.no
Source
Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1005-11
Date
Mar-15-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Case-Control Studies
Cohort Studies
Defecation - radiation effects
Dose Fractionation
Fecal Incontinence - etiology
Female
Health status
Humans
Male
Middle Aged
Norway
Patient Selection
Quality of Life
Questionnaires
Rectal Neoplasms - drug therapy - radiotherapy - surgery
Rectum - surgery
Regression Analysis
Surgical Stomas
Urinary Incontinence - etiology
Abstract
PURPOSE: There is little knowledge on long-term morbidity after radiotherapy (50 Gy) and total mesorectal excision for rectal cancer. Therefore, late effects on bowel, anorectal, and urinary function, and health-related quality of life (QoL), were studied in a national cohort (n = 535). METHODS AND MATERIALS: All Norwegian patients who received pre- or postoperative (chemo-)radiotherapy for rectal cancer from 1993 to 2003 were identified. Patients treated with surgery alone served as controls. Patients were without recurrence or metastases. Bowel and urinary function was scored with the LENT SOMA scale and the St. Marks Score for fecal incontinence and QoL with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). RESULTS: Median time since surgery was 4.8 years. Radiation-treated (RT+) patients (n = 199) had increased bowel frequency compared with non-radiation-treated (RT-) patients (n = 336); 19% vs. 6% had more than eight daily bowel movements (p
PubMed ID
19540058 View in PubMed
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