Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
Department of Engineering, University College London, London, UK.
BMJ Case Rep. 2022 May 13;15(5):e246037. doi: 10.1136/bcr-2021-246037.
Stoma formation for patients with dementia presents an increasing problem in a global ageing population. While potentially lifesaving, stomas impose significant, long-term postoperative burdens on patients, and may particularly challenge those with cognitive impairment.In this case, a patient was considered for colostomy to manage a colovesical fistula. The patient's cognitive status significantly influenced clinicians' beliefs concerning suitability for stoma formation.The relevance of dementia to stoma formation is underdiscussed within the literature. In this report, we outline the postoperative risks to which those with dementia undergoing stoma formation are particularly vulnerable. These include increased risk of psychological harm, of relocation to a nursing home, and of stoma-related complications.We hope an increased appreciation of these postoperative challenges will inform decisions concerning suitability for stoma formation in this patient group.
在全球人口老龄化的背景下，痴呆症患者的造口问题日益突出。虽然造口术可能挽救生命，但它会给患者带来长期的重大术后负担，特别是对认知障碍患者而言。在本例中，一位患者被考虑行结肠造口术以治疗结肠膀胱瘘。患者的认知状态显著影响了临床医生对造口术适用性的看法。痴呆症与造口术的相关性在文献中讨论较少。在本报告中，我们概述了痴呆症患者行造口术特别容易面临的术后风险。这些风险包括心理伤害、搬入养老院和造口相关并发症的风险增加。我们希望对这些术后挑战的认识提高将有助于为这组患者决定是否适合行造口术。
