A modified TSBV medium has been prepared in Vietnam. This procedure was simple, unexpensive and easy to implement in the microbial laboratories. The medium inhibited most of microbials in the stoma and facilitated the good development of actino bacillus actinomycetem comitants
microbiology ; Stomas

Humans ; Surgical Stomas

Humans ; Rectal Neoplasms ; Surgical Stomas

This paper describes the background of Chinese expert consensus on protective ostomy for middle and low rectal cancer in China, interprets some key issues such as unification of relevant terminology and concepts, clinical value and indications of protective stoma, and clarifies surgical principles and details and perioperative ostomy care.
China ; Consensus ; Humans ; Ostomy ; Rectal Neoplasms/surgery* ; Surgical Stomas

Colon, Sigmoid/surgery* ; Colostomy ; Humans ; Ostomy ; Prolapse ; Surgical Stomas

Stoma is a commonly used surgical procedure in clinic practice. However, for obese patients with thick abdominal wall, short and thickened mesentery, and for patients with intestinal obstruction and abdominal distension (difficult stoma), establishing a tension- free and well blood-supplied stoma is still a great challenge. Careful preoperative planning, including stoma location marking, careful consideration of all alternatives and attention to technical details, will help to make an optimal stoma under challenging conditions. For enterostomy of obese patients, the pullout intestine must be free of tension and must have sufficient blood supply, the structure of the abdominal wall should be incised vertically, and the intestine should be pulled out vertically as well. For enterostomy of patients with intestinal obstruction, the diameter of the stoma incision should not exceed 3 cm to avoid parastomal hernia, which commonly occurs after bowel retraction.
Humans ; Surgical Stomas ; Incisional Hernia ; Enterostomy ; Intestinal Obstruction ; Obesity

Enterostomy-related complications are common in abdominal surgery. The incidence enterostomy-related complications varies according to the type and location of stoma, surgical procedure, and patient characteristics. Currently, there are no uniform criteria wopldwide for the classification of enterostomy complications. Previous classification of enterostomy-related complications were based on time of occurrence, clinical manifestations, or anatomical changes, etc., lacking uniformity and reproducibility. The concept and diagnostic criteria of complications are not yet clearly defined; and it is difficult to accurately determine the relationship between their severity, intervention, and medical cost. Moreover, surgeons and enterostomal therapists differ significantly in their concerns, cognition, and management principles for stoma-related complications. Therefore,the Chinese Ostomy Collaboration Group (COCG), together with the Wound, Ostomy, and Continence Nursing Committee of Chinese Nursing Association, the Colon and Rectal Surgeon Committee of Surgeon Branch of Chinese Medical Doctor Association, the Committee of Colorectal Cancer of Chinese Anti-Cancer Association, and the Colorectal Surgery Group of Surgery Branch of the Chinese Medical Association, jointly drafted the criteria for the classification and grading of enterostomy complications. We hope this criteria will facilitate prospective data collection, clinical diagnosis, treatment, medical training and education.
Humans ; Reproducibility of Results ; Enterostomy/adverse effects* ; Surgical Stomas ; Rectum ; Colon

PURPOSE: Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. METHODS: This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. RESULTS: Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). CONCLUSION: After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.
Cicatrix ; Humans ; Ileostomy* ; Incidence ; Methods ; Patient Satisfaction ; Skin* ; Surgical Stomas ; Wound Infection ; Wounds and Injuries*

PURPOSE: To investigate the efficacy and safety of the transanal tube (TAT) in preventing anastomotic leak (AL) in rectal cancer surgery. METHODS: Clinical data of the patients who underwent curative surgery for mid rectal cancer from February 2010 to February 2014 were reviewed retrospectively. Rectal cancers arising 5 to 10 cm above the anal verge were selected. Patients were divided into the ileostomy, TAT, or no-protection groups. Postoperative complications including AL and postoperative course were compared. RESULTS: We included 137 patients: 67, 35, and 35 patients were included in the ileostomy, TAT, and no-protection groups, respectively. Operation time was longer in the ileostomy group (P = 0.029), and more estimated blood loss was observed (P = 0.018). AL occurred in 5 patients (7.5%) in the ileostomy group, 1 patients (2.9%) in the TAT group, and 6 patients (17.1%) in the no-protection group (P = 0.125). Patients in the ileostomy group resumed diet more than 1 day earlier than those in the other groups (P = 0.000). Patients in the no-protection group had about 1 or 2 days longer postoperative hospital stay (P = 0.048). The ileostomy group showed higher late complication rates than the other groups as complications associated with the stoma itself or repair operation developed (P = 0.019). CONCLUSION: For mid rectal cancer surgery, the TAT supports anastomotic site protection and diverts ileostomy-related complications. Further large scale randomized controlled studies are needed to gain more evidence and expand the range of TAT usage.
Anastomotic Leak ; Diet ; Drainage ; Humans ; Ileostomy* ; Length of Stay ; Postoperative Complications ; Rectal Neoplasms* ; Retrospective Studies* ; Surgical Stomas

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.