Department of Chirurgia Generale E Oncologica, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Turin, Italy.
Clinical Trial Unit, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Turin, Italy.
Int J Colorectal Dis. 2022 Jul;37(7):1719-1725. doi: 10.1007/s00384-022-04200-z. Epub 2022 Jun 10.
New stoma creation is related to a wide range of implications and stoma-related complications could occur frequently. The aim was to assess the impact of a close stoma-therapeutic-care pathway (STCP) in terms of length of stay, autonomy in the management of the pouch, readmission rate, and stoma-related complications.
Patients undergoing surgery for colorectal disease and first stoma creation from January 2017 to December 2020 were analyzed. All patients enrolled had joined the Enhanced Recovery after Surgery (ERAS) protocol.
Among 143 enrolled, 56 (40%) did not completely follow the STCP (group A), whereas 87 (60%) demonstrated strict compliance (group B). The hospital stay lasted 8 days in group B and 11.5 in group A (p = 0.001). The first look at the stoma needed 1 day in group B and 3 days in group A (p < 0.001), emptying the pouch 2 days in group B and 5 days in group A (p < 0.001). Finally, the ability to change the pouch was 3 days in group B and 6 days in group A (p < 0.001). Nine (16.1%) stoma-related complications were counted in group A and 16 (18.4%) in group B, and 30-day readmission was 10.1% in group B and 11.5% in group A (p = 0.82 and p = 1, respectively, not significant).
The STCP has been shown to reduce the hospital stay and to have a protective role making the patient autonomous in the management of the stoma.
新造口与广泛的影响相关，并且可能经常发生与造口相关的并发症。本研究旨在评估紧密造口治疗护理路径（STCP）在住院时间、造口袋管理自主性、再入院率和造口相关并发症方面的影响。
分析了 2017 年 1 月至 2020 年 12 月接受结直肠疾病手术和首次造口的患者。所有入组患者均加入了加速康复外科（ERAS）方案。
在 143 名入组患者中，56 名（40%）不完全遵循 STCP（A 组），而 87 名（60%）表现出严格的依从性（B 组）。B 组的住院时间为 8 天，A 组为 11.5 天（p=0.001）。B 组首次查看造口需要 1 天，A 组需要 3 天（p<0.001），排空造口袋 B 组需要 2 天，A 组需要 5 天（p<0.001）。最后，B 组更换造口袋的能力为 3 天，A 组为 6 天（p<0.001）。A 组有 9 例（16.1%）造口相关并发症，B 组有 16 例（18.4%），B 组 30 天再入院率为 10.1%，A 组为 11.5%（p=0.82 和 p=1，均无显著性差异）。
STCP 已被证明可以缩短住院时间，并在造口管理方面发挥保护作用，使患者具有自主性。
