[目的]系统评价影响肠造口周围皮肤并发症发生的因素。[方法]计算机检索the Cochrane Library、JBI、中国生物医学文献数据库(CBM)、知网、万方、Web of Science、PubMed、CINAHL等中英文数据库,检索时限均为从建库至2019年8月31日,由2...[目的]系统评价影响肠造口周围皮肤并发症发生的因素。[方法]计算机检索the Cochrane Library、JBI、中国生物医学文献数据库(CBM)、知网、万方、Web of Science、PubMed、CINAHL等中英文数据库,检索时限均为从建库至2019年8月31日,由2名研究者分别独立进行文献的筛选和信息提取、利用澳大利亚JBI卫生保健中心质量评价工具(2016版)对文献质量进行评价,对研究结果进行描述性分析。[结果]按照纳入和排除标准最终纳入24篇文献。定性分析结果显示:依据不同影响因素进行分类归纳,将影响肠造口周围皮肤并发症的因素分为一般资料相关因素、手术相关因素、造口本身因素、排泄相关因素、造口护理、教育和指导相关因素、原发疾病、并存疾病、辅助治疗相关因素、造口用品和经济相关因素7个方面33个因素。[结论]当前证据显示,影响肠造口周围皮肤并发症发生因素较多,但由于纳入文献总体质量不高,同时,研究间在研究设计、结局指标选择方面存在较大异质性,因此期待更多高质量研究进一步验证。展开更多
To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized techn...To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.展开更多
文摘[目的]系统评价影响肠造口周围皮肤并发症发生的因素。[方法]计算机检索the Cochrane Library、JBI、中国生物医学文献数据库(CBM)、知网、万方、Web of Science、PubMed、CINAHL等中英文数据库,检索时限均为从建库至2019年8月31日,由2名研究者分别独立进行文献的筛选和信息提取、利用澳大利亚JBI卫生保健中心质量评价工具(2016版)对文献质量进行评价,对研究结果进行描述性分析。[结果]按照纳入和排除标准最终纳入24篇文献。定性分析结果显示:依据不同影响因素进行分类归纳,将影响肠造口周围皮肤并发症的因素分为一般资料相关因素、手术相关因素、造口本身因素、排泄相关因素、造口护理、教育和指导相关因素、原发疾病、并存疾病、辅助治疗相关因素、造口用品和经济相关因素7个方面33个因素。[结论]当前证据显示,影响肠造口周围皮肤并发症发生因素较多,但由于纳入文献总体质量不高,同时,研究间在研究设计、结局指标选择方面存在较大异质性,因此期待更多高质量研究进一步验证。
文摘To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.
