Journal of Japanese Society of Stoma and Continence Rehabilitation
Online ISSN : 2434-3056
Print ISSN : 1882-0115
Volume 40, Issue 2
Total111
Displaying 1-23 of 23 articles from this issue
  • Yoshiko Ando, Arata Takahashi, Makoto Fujii, Hiroshi Hasegawa, Toshimo ...
    2024Volume 40Issue 2 Pages 46-61
    Published: 2024
    Released on J-STAGE: June 03, 2024
    JOURNAL FREE ACCESS

    Background and Aim: In Japan, the actual number of stoma constructions and stoma closures is not known. The aim of this study was to conduct a survey to determine the number of gastrointestinal stoma constructions and closures in Japan.

    Methods: Enrolled participants comprised patients undergoing selected gastrointestinal surgeries who were recorded in the National Clinical Database. This database uses the "Common Items for Gastrointestinal Surgeons”. These procedures were formulated by the Japanese Society of Gastroenterological Surgery during 2013-2018.

    Results: According to the National Clinical Database, a total of 154,323 gastrointestinal stomas were constructed between January 1, 2013 and December 31, 2018. By procedure, there were 78,723 cases of stoma construction, 39,653 of abdominoperineal resection, 2,470 total pelvic exenteration procedures, and 33,572 Hartmann’s procedures. The ratio of stoma closures to stoma constructions increased annually in patients under 70 years of age but not in older patients. Approximately 35% of total colectomies, 60% of proctocolectomies, and 20% of low anterior resections were accompanied by stoma construction. The number ofpatients with rectal cancer who underwent colostomy increased gradually during the study period and the number who underwent stoma construction increased among older patients.

    Conclusions: The number of cases of gastrointestinal stoma construction has increased gradually in Japan, and the proportion of older patients is increasing each year. The purposes and surgical techniques for stoma construction are diverse and are expected to increase in Japan, a super-aged society.

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  • Hiroaki Nozawa, Sanae Sasaki, Chieko Hayashi, Akiko Kawasaki, Kazuhito ...
    2024Volume 40Issue 2 Pages 62-74
    Published: 2024
    Released on J-STAGE: June 03, 2024
    JOURNAL FREE ACCESS

    Purpose: Stoma site marking is an important factor in reducing stoma-related complications, thereby influencing the long-term quality of life in the elective setting. The impact of preoperative stoma site marking in emergency stoma creation is largely unknown. We aimed to determine whether preoperative stoma site marking in emergency stoma creation reduces stoma-related complications.

    Methods: Patients who underwent emergency stoma creation at our hospital between 2009 and 2022 were examined by reviewing our prospective database and retrospective chart review. Subjects were classified into the “marking (+)” or “marking (-)” group according to stoma site marking (194 and 151 patients, respectively). The changes in the frequency of stoma marking over time and the effects of stoma marking on stoma-related complications were analyzed.

    Results: The overall frequency of grade 2 or higher stoma-related complications was lower in the marking (+) group than in the marking (-) group (24% vs 36%, p=0.010). Stoma site marking was associated with fewer soma site bleeding (2%vs 10%, p<0.001), and the frequency of peristomal dermatitis was also lower (10%) in the marking (+) group (vs 18%, p=0.042). Moreover, the lack of stoma site marking was an independent risk factor for overall stoma-related complications (adjusted odds ratio: 1.69, p=0.034).

    Conclusion: Preoperative stoma site marking was associated with stoma-related complications in emergency surgery. The clinical significance of our attempt is worth validating with prospective studies.

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  • Yukiko Tachibana, Kazuyoshi Shirakawa, Madoka Oshige, Keiko Miyazaki
    2024Volume 40Issue 2 Pages 75-86
    Published: 2024
    Released on J-STAGE: June 03, 2024
    JOURNAL FREE ACCESS

    Purpose: To examine the positive impact of our original “flowchart for selecting ostomy appliances” (FLOWCHART) and “portable ostomy appliance set” (SET), introduced in September 2019, on the early selection of an appropriate ostomy appliance.

    Methods: The subjects were patients who had an intestinal stoma created between September 2018 and September 2020. They were divided into groups of those who underwent stoma creation before (Before Group, BG) or after (After Group, AG) the introduction of the FLOWCHART and SET. The two groups were compared regarding the time from stoma creation to ostomy appliance decision (Decision time), the number of appliance exchanges, and the rate of appliance-type change at their first visit to the stoma outpatient clinic.

    Results: In total, 176 patients were analyzed. Their mean age (±SD) was 64.2±13.8 years and 101 (57%) were men. The BG and AG comprised 91 and 85 patients, respectively. The Decision time was significantly shorter in the AG than in the BG (13.1 vs. 18.3 days, p < 0.001). The mean number of appliance exchanges was significantly smaller in the AG than in the BG (5.8 vs. 8.5 times, p < 0.001). The rate of appliance-type change was also significantly smaller in the AG than in the BG (17% vs. 51%, p = 0.0001).

    Conclusion: These results suggest that the FLOWCHART and SET are effective for facilitating the early selection of an appropriate ostomy appliance.

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  • Mitsuhiko Shibasaki, Rie Maeuma
    2024Volume 40Issue 2 Pages 87-102
    Published: 2024
    Released on J-STAGE: June 03, 2024
    JOURNAL FREE ACCESS

    Purpose: The aim of this study was to elucidate the relationship between quality of life (QOL) and willingness to cope with difficulties in stoma management and problems in daily life (“willingness”), as well as health literacy, in ostomates living at home.

    Methods: A questionnaire was distributed to all 555 members of the Osaka and Hyogo Ostomy Associations by mail. QOL was evaluated using a short version of the ostomate QOL questionnaire. “Willingness” was measured on a scale ranging from 0 to 10. The 14-item health literacy scale (HLS-14) was used to evaluate health literacy. The relationship between QOL and “willingness”, as well as health literacy, was examined by multiple linear regression analysis with the forced entry method.

    Results: Of the 205 respondents, 103 (average age 73.1 years, 50 males) without missing answers to the question item for “willingness” were analyzed (valid response rate 18.6%). On multiple linear regression analysis, higher “willingness” and functional health literacy were significantly associated with better QOL, but communication and critical health literacies were not significantly associated.

    Conclusion: The QOL of ostomates might be improved by supporting the enhancement of their “willingness” and the improvement of their functional health literacy.

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  • Toshiaki Tanaka
    2024Volume 40Issue 2 Pages 103-117
    Published: 2024
    Released on J-STAGE: June 03, 2024
    JOURNAL FREE ACCESS

    Radical cystectomy is the standard definitive treatment for bladder cancer. The procedure is highly invasive and requires urinary diversion, resulting in significant changes in lifestyle for patients. To reduce the invasiveness, the use of robot-assisted radical cystectomy has gained popularity; however, its superiority over open surgery has not been fully elucidated, except for observation of the minimization of the wound and significant reductions in intraoperative blood loss. Although various procedures for urinary diversion have been developed, the ease of management and low risk of complications are emphasized when selecting a procedure. As a result, ileal conduit and ileal neobladder are currently the most common procedures. Ileal conduit is the standard procedure, whereas ileal neobladder is selected for appropriate patients. Radical cystectomy with urinary diversion is associated with distinctive complications that physicians and medical staff should keep in mind to ensure the appropriate management of patients, even in later stages. In addition, shared decision making supported by an interdisciplinary team and postoperative continuous support may improve patients’ quality of life as well as their satisfaction.

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