Silva Michael Anthony, Ratnayake Geethani, Deen Kemal I
Department of General Surgery, University Surgical Unit, Teaching Hospital, Talagolla Road, Ragama, Sri Lanka.
World J Surg. 2003 Apr;27(4):421-4. doi: 10.1007/s00268-002-6699-4.
Ileostomy for proximal diversion as a preferred option over colostomy has been a recent topic of interest. Our study evaluated the quality of life (QOL) of patients with a temporary ileostomy and compared it with that of patients with a temporary colostomy. The QOL of 25 patients with an ileostomy (median age 42 years, range 22-76 years) was compared with that for 25 patients with a colostomy (median age 44 years, range 18-70 years). Indications for a stoma were rectal carcinoma, trauma, inflammatory bowel disease, anastomotic leak, or incontinence following an operative procedure for rectal prolapse. The study was conducted at a median of 8 weeks (range 6-16 weeks) for ileostomy patients and of 9 weeks (range 5-17 weeks) for colostomy patients following stoma creation. A self-administered structured questionnaire was used, with responses obtained for 10 QOL questions on a visual analog rating scale (0-100 mm); they were graded good (71-100), satisfactory (31-70), or poor (0-30). Altogether, 22 (88%) patients with an ileostomy, compared with 16 (64%) patients with a colostomy, were able to purchase their stomal appliances ( p = 0.09, chi(2): NS). Effluent was tolerable in 18 (72%) patients with an ileostomy compared with 7 (28%) patients with a colostomy ( p = 0.002, chi(2)). Appetite was not affected in any of the patients with an ileostomy (100%), compared with 64% of patients with a colostomy ( p = 0.002, chi(2)), travel by public transport 32% compared to 28% with colostomy (NS), dress in 20% compared to 24% with colostomy (NS), and daily activities 28% compared to 24% with colostomy (NS). Moreover, 68% with an ileostomy did not have a problem with hygiene compared with 40% with a colostomy (NS); 95% with an ileostomy abstained from sexual activity compared with 81% with a colostomy ( p = 0.21, chi(2): NS). Both ileostomy and colostomy resulted in significant QOL impairment. However, with ileostomy, the effluent was more tolerable, had less of an impact on personal hygiene, and preserved the appetite compared with colostomy. There were no differences in travel, dress, daily chores, or sexual activity between the two groups.
回肠造口术作为近端转流的首选方式，相较于结肠造口术，已成为近期备受关注的话题。我们的研究评估了临时回肠造口术患者的生活质量（QOL），并将其与临时结肠造口术患者的生活质量进行了比较。将25例回肠造口术患者（中位年龄42岁，范围22 - 76岁）的生活质量与25例结肠造口术患者（中位年龄44岁，范围18 - 70岁）的生活质量进行了比较。造口的适应证包括直肠癌、创伤、炎症性肠病、吻合口漏或直肠脱垂手术后的失禁。该研究在回肠造口术患者造口术后中位8周（范围6 - 16周）、结肠造口术患者造口术后中位9周（范围5 - 17周）时进行。使用了一份自我管理的结构化问卷，通过视觉模拟评分量表（0 - 100毫米）获取了10个生活质量问题的答案；答案被评为良好（71 - 100）、满意（31 - 70）或差（0 - 30）。总的来说，22例（88%）回肠造口术患者能够购买造口用品，而结肠造口术患者为16例（64%）（p = 0.09，卡方检验：无显著性差异）。18例（72%）回肠造口术患者的排泄物可耐受，而结肠造口术患者为7例（28%）（p = 0.002，卡方检验）。回肠造口术患者中无一例（100%）食欲受影响，而结肠造口术患者为64%（p = 0.002，卡方检验）；乘坐公共交通工具出行方面，回肠造口术患者为32%，结肠造口术患者为28%（无显著性差异）；着装方面，回肠造口术患者为20%，结肠造口术患者为24%（无显著性差异）；日常活动方面，回肠造口术患者为28%，结肠造口术患者为24%（无显著性差异）。此外，68%的回肠造口术患者在卫生方面没有问题，而结肠造口术患者为40%（无显著性差异）；95%的回肠造口术患者避免性行为，而结肠造口术患者为81%（p = 0.21，卡方检验：无显著性差异）。回肠造口术和结肠造口术均导致显著的生活质量损害。然而，与结肠造口术相比，回肠造口术的排泄物更易耐受，对个人卫生影响较小，且能保持食欲。两组在出行、着装、日常琐事或性行为方面没有差异。
