The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.
Colostomy ; Depression ; Education ; Humans ; Male ; Odors ; Ostomy ; Quality of Life ; Rehabilitation

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

No abstract available.
Hernia ; Ostomy ; Risk Factors

PURPOSE: This survey was designed to acknowledge that it is necessary to rehabilitate ostomates. METHODS: This medical survey attempted to make an analysis of the types and causes of stoma, the problems stemming from the stoma, the degree to which ostomates are satisfied with their life quality, and the extent to which they are affected in doing their jobs, on the basis of the examinations conducted for eighty eight ostomates, who responded to the questionnaire at the 3rd Workshop for Stoma Rehabilitation for Ostomates on August 29, 1998 by the Department of Surgery, Kyung-Hee University Hospital, or who replied back to the questionnaire that was sent by mail. RESULTS: On examination, it was found that the ratio of male to female was nearly 1.5:1 (53:35); by age distribution, the ostomates in their 50 and 60's constituted 65.9%; by stoma pattern, colostomy was made up of 81 cases (92%), ileostomy 4 cases (4.5%), urostomy 2 cases (2.3%); by duration, permanent stoma was 81 cases (92%), temporary stoma 6 cases (6.8%); by the cause of stoma operation, malignancy consisted of 78 cases (88.6%), IBD 4 cases (4.5%), congenital anomaly 1 case, car accident 1 case, benign bladder disease 1 case, intestinal obstruction after radiation therapy 1 case, but 2 cases were not identified. Besides, it was also examined that, regarding the degree of post-operation satisfaction for stoma, dissatisfaction amounted to 58 cases (65.9%); as for the problems stemming from the stoma, skin irritation or injury reached 30 cases (34.1%), discomfort for stoma location 17 cases (19.35%), parastomal hernia 8 cases (9.1%), stoma retraction 4 cases (4.5%) and disease recurrence 3 cases (3.4%); as for the degree of the satisfaction of ostomates for their life quality, dissatisfaction revealed 70 cases (79.5%); regarding the extent to which the ostomates are affected in doing their jobs, fifty four out of eighty eight ostomates (62.0%) had a disturbance. CONCLUSIONS: This medical survey clearly shows that most of ostomates suffered from stoma in their daily lives and doing their occupations, thus they need helps from the experts such as colorectal surgeons and enterostomal therapists, or the ostomy association. In addition, it is also necessary to pay a more deliberate attention to determining the location of stoma.
Age Distribution ; Colostomy ; Education ; Female ; Hernia ; Humans ; Ileostomy ; Intestinal Obstruction ; Male ; Occupations ; Ostomy ; Postal Service ; Quality of Life ; Surveys and Questionnaires ; Recurrence ; Rehabilitation ; Skin ; Urinary Bladder Diseases

The study was conducted to compare the quality life (QOL), health perception and self efficacy of the ostomates by the fecal control type. The study sbjects included 128 ostomates in Pusan, Daegu, Daejon and Incheon branches of the Korean Ostomy Association. Data collection was performed for 27 day periods from September 10th to October 6th. 1988. The instruments used in this study were the OL scale developed by Bang (1991). the health perception scale developed by Ware and translated to Korean by Lee (1987), the self efficacy scale developed by Kim( 1995). The analysis of the data was done by the use of descriptive statistics. Chi-square test, ANCOVA and Pearson Correlation with the SAS program. The results of the study are summarized below. 1. Only age was a significant difference between the two groups(p=.014). 2. The ostomate-related characteristics which showed significant differences were the number of participations in the ostomate meetings each month(p=.001). the care manager(p=.017), the number of defecations(p=.001). problems with the colostomy(p=.003), the duration of the ostomates(p=.00l). These variables were controlled using the ANCOVA. 3. The first hypothesis. "There will be differences at the level of the QOL according to the fecal control type" was supported(F=7.87, p .0059). 4. The second hypothesis. "There will be differences at the level of health perception depending on the fecal control type" was supported (F =8.68, p = .0039). 5. The third hypothesis, "There will be differences at the level of self efficacy depending on the fecal control type" was supported(F=4.58. p=.0344). 6. There were significant positive correlation between the QOL and health perception(r= .8225. p=.0001), and self efficacy(r=.6356, p=000l). From the above results, it can be concluded that colostomy irrigation is a good method to improve the QOL, health perception and self-efficacy. Therefore, colostomy irrigation is an important method for rehabilitation nursing use in the care of ostomates.
Busan ; Colostomy ; Daegu ; Daejeon ; Data Collection ; Health Status ; Incheon ; Ostomy ; Quality of Life* ; Rehabilitation Nursing ; Self Efficacy

Malnutrition and weight loss after total gastrectomy is one of the major concerns of surgeons. In order to improve the nutritional status in these patients, many surgeons have tried to restore the duodenal passage as reconstructive procedure but debates have been continued. So we investigated weight change, postprandial serum secretin response and fecal fat amount to evaluate the esophagojejunoduodenostomy after which the duodenal passage was restored. Total gastrectomized dogs showed significant weight loss and all experimental animals except sham operation died between five and eight weeks after the operation. Serum secretin concentration after esophagojejunoduodenostomy increased significantly from a mean fasting value of 100 +/- 12.5 pg/mL to a mean peak of 142 +/- 22.5 pg/mL at 40 minutes and returned to the fasting level at 120 minutes postprandially. But fasting and postprandial serum secretin concentration in patients following Roux-en Y esophagojejunostomy were fluctuated irregularly. The amount of fecal fat in esophagojejunoduodenostomy was 5.3 +/- 1.2 gm/100 gm stool, which was not different from that of the control group but in Roux-en Y esophagojejunostomy it was 28.1 +/- 4.1 gm/100 gm stool which was much higher than that observed in esophagojejunoduodenostomy and in control group. These results suggest that esophagojejunoduodenostomy is superior to Roux-en Y esophagojejunostomy in respect to pancreatic secretory function and fat absorption.
Anastomosis, Roux-en-Y ; Animal ; *Animal Nutrition ; Dogs ; Duodenostomy ; Esophagostomy ; *Gastrectomy ; Jejunostomy ; Support, Non-U.S. Gov't

PURPOSE: Malignant bowel obstruction caused by recurrent gastric cancer must be treated appropriately to improve the effects of treatment and to prolong survival. We reviewed the surgical treatments for malignant bowel obstruction caused by recurrent gastric cancer. MATERIALS AND METHODS: The subjects were patients with malignant bowel obstruction caused by recurrent gastric cancer and these patients were treated by surgical procedures at our hospital from 1998 to 2008. The patients were treated by resection, ostomy or bypass. The success of treatment was decided when the patients were able to tolerate more than a liquid diet. RESULTS: 42 patients were treated 46 times by surgical procedures. Resection was done12 times, ostomy was done 24 times and bypass was done 10 times. The hospital stay and the period to liquid diet after the operation were shorter in the ostomy group. The post operative morbidity rate was 21.7% and the post operative death rate was 8.7%. There was no significant difference in survival according to the type of surgery. CONCLUSION: Ostomy is good choice for selected patients because it has a shorter hospital stay and period to liquid diet. There was no significant difference in survival according to the type of surgery because curative resection is difficult to perform in patients with malignant bowel obstruction.
Diet ; Humans ; Length of Stay ; Ostomy ; Stomach Neoplasms

BACKGROUND: There has been a general feeling among surgeons that recurrence or metastasis following a curative gastric resection is a hopeless surgical proposition. This study was conducted to evaluate the clinical features and significance of relaparotomy following a gastrectomy for gastric cancer. METHODS: Fifty-six cases of relaparotomies following resection for 53 gastric cancer patients, which were performed over a nine-year period, were investigated retrospectively. On preoperative diagnosis, there were 17 cases of remnant and anastomotic recurrence, 15 cases of intestinal obstruction, 7 cases of cholecystitis, 7 cases of rectosigmoid obstruction, 5 cases of E-loop obstruction and 5 cases of other diseases. RESULTS: Of all the laparotomies eleven cases (19%) were non-recurrence, benign diseases and forty-six (81%) were recurrence. In the 17 cases of remnant and anastomotic recurrence, re-resection was possible in 13 (76%) and major postoperative complications developed in 4 cases with 2 cases of death within one month. Also 6 of 7 re-resected cases which was stage I at first operation were still alive well. In 15 cases of mechanical obstruction, 5 cases were non-recurrence and 10 cases involved recurrence, of which 6 had a bypass or enterostomy and 4 an exploration only. All cholecystitis cases had a cholecystectomy; metastasis was found in 2 cases. Rectal obstruction and E-loop obstruction all involved recurrence and a palliative resection was possible in only one case of each type of obstruction. CONCLUSIONS: In a relaparotomy of remnant and anastomotic recurrence, most of the survival-improving re-resection cases were in stage I at the first operation. In late-onset cholecystitis tumor recurrence should be suspected and a relaparotomy of the malignant obstruction, with bypass and ostomy procedure, can be justified for symptomatic relief.
Cholecystectomy ; Cholecystitis ; Diagnosis ; Enterostomy ; Gastrectomy ; Humans ; Intestinal Obstruction ; Laparotomy ; Neoplasm Metastasis ; Ostomy ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical education materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and resonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company. Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analyzed of education guide, on ostomate included 14 subcategories ; introduction, structure and fuction of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defection management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostmates to understand their physical structure change with specific explanation on gastrointestinal tracts with figures. 4. Six institution did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations in natural defecation are needed. The benefits and pitfalls in natural defection should be more specified. 7. No psychosocial difficulties of ostomy management were addressed. 8. The efficiency off enema can be better understand through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgery. 11. Most institution explained sucategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations in normal structure and function of urinary tracts, types of ureterostomy, how to management skin, usage and types instrument, commercial urostomy, how to manage instrument, daily life, introduction the general contents. However, more specific explanations were needed.
Defecation ; Education ; Education, Nursing ; Enema ; Gastrointestinal Tract ; Hospitals, University ; Life Style ; Nursing ; Ostomy ; Peristalsis ; Quality of Life ; Seoul ; Skin ; Ureterostomy ; Urinary Tract

OBJECTIVE: The purpose of this study was to develop a Web-based ostomy self-care education program and to evaluate its effects on ostomates' self-care knowledge and self-care behavior. METHODS: Based on the needs assessment and literature review, a Web-based ostomy self-care education program was developed and modified incorporating feedbacks from nurse experts panel. The experimental group received the ostomy self-care using the Web-based program and the control group received the traditional education. The level of self-care knowledge and self-care behavior were measured and were compared between the experimental and the control groups. RESULTS: The levels of self-care knowledge and self-care behavior in the experimental group were significantly higher than those of the control group. CONCLUSION: This study implies that a Web-based education program for the ostomates can be used to improve ostomy self-care.
Education* ; Internet ; Needs Assessment ; Ostomy* ; Patient Education as Topic ; Self Care*