Introduction: This study aimed to evaluate whether functional screening, as assessed by the Geriatric-8 (G8) and the instrumental activities of daily living (IADL)-modified G8, are associated with the inability to manage a stoma by themselves in patients with bladder cancer who underwent robot-assisted radical cystectomy.
Materials And Methods: We analyzed a total of 110 consecutive patients with bladder cancer who underwent robot-assisted radical cystectomy and were screened preoperatively using the G8 and the IADL-modified G8 at our institution between January 2020 and December 2022. Patients who could not undergo geriatric screening at the preoperative clinic before surgery and patients who underwent orthotopic neobladder construction were excluded. We evaluated the association between clinical factors, including scores of G8 and IADL-modified G8, and the inability to manage a stoma by oneself. For both G8 and IADL-modified G8, a cutoff value of ≤14 was set.
Results: Of the 110 patients, the median age was 77 years, 92 (84%) patients were male and 47 (43%) patients were unable to manage a stoma by themselves. The geriatric assessment indicated that 64 patients (58%) were classified in the low G8 (≤14) group and 66 patients (60%) were classified in the low IADL-modified G8 (≤14) group. The values of area under the receiver operating characteristic curve for predicting inability to manage stoma by oneself were 0.725 for the G8 and 0.734 for the IADL-modified G8, respectively. Multivariate analysis including the G8 revealed that age ≥ 80, Charlson comorbidity index of ≥3, and G8 ≤ 14 (odds ratio [OR] = 4.9; 95% confidence interval [CI] = 1.8-13.0; P = 0.002) were independent risk factors for inability to manage a stoma by oneself. Likewise, multivariate analysis including the IADL-modified G8 revealed that age ≥ 80, Charlson comorbidity index of ≥3, and IADL-modified G8 ≤ 14 (OR = 5.4; 95% CI = 1.9-14.0; P = 0.001) were independent risk factors for inability to manage a stoma by oneself.
Discussion: Screening using G8 and IADL-modified G8 may predict patients who have difficulty self-managing their stomas.
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http://dx.doi.org/10.1016/j.jgo.2023.101468 | DOI Listing |
Oper Orthop Traumatol
January 2025
Klinik für Unfall‑, Hand und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
Objective: Treatment with transcutaneous osseointegrated prosthesis systems (TOPS) for short femoral amputation stumps aims to restore independent walking ability after proximal femoral amputation by direct bone-guided prosthesis anchorage. This cannot be safely achieved with conventional socket prostheses due to the mechanically inadequate socket contact surface.
Indications: Treatment of patients with short transfemoral stumps who cannot be mobilized sufficiently with conventional socket prostheses.
BMC Gastroenterol
January 2025
Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050000, China.
Purpose: The relationship between high-output stoma (HOS) and low anterior resection syndrome (LARS) was previously unclear. This study investigated the association between HOS and major LARS in rectal cancer patients with preventive stoma.
Methods: We conducted a retrospective analysis of 653 rectal cancer patients who underwent prophylactic ileostomy reversal after low anterior resection at the Fourth Hospital of Hebei Medical University between 2018 and 2021.
Minerva Surg
January 2025
San Marco - Ambulatorio Infermieristico Care Nursing Team, G. Rodolico University Hospital, Catania, Italy.
Stoma surgery is frequently used to treat conditions such as colorectal cancer and inflammatory diseases. While it can extend patients' lives, it often introduces challenges that negatively affect quality of life. Convex skin barriers are commonly recommended for managing flat or retracted stomas and addressing irregular peristomal surfaces, such as creases or folds.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of General Surgery, Shanghai Fengxian District Central Hospital, Shanghai, China.
Introduction: In colostomy-related complications, variceal hemorrhage particularly induced by cirrhosis and portal hypertension is seldom encountered. The onset of peristome variceal hemorrhage necessitates swift and effective intervention to prevent potentially life-threatening outcomes such as hemorrhagic shock and recurrent stoma bleeding.
Case Presentation: This report details a case of repeated varicose vein hemorrhage around the stoma in a patient with liver cirrhosis.
J Wound Ostomy Continence Nurs
January 2025
Kyriaki Stefania Mitsaki, MBBCh, BSc (Hons), MSc, MRCP, Department of Dermatology, Northwick Park Hospital, London North West University Hospital NHS Trust, London, UK.
Background: Peristomal pyoderma gangrenosum (PPG) is a non-infectious neutrophilic dermatosis most commonly seen in the context of ostomies in inflammatory bowel disease. The lack of established treatment guidelines and high-quality evidence in the form of randomized controlled trials present a major challenge in PPG management, owing to the rarity of the condition. Treatment can be further complicated by difficulties in maintaining the stoma pouch seal with conventional topical corticosteroids.
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