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Stoma (medicine)

About: Stoma (medicine) is a research topic. Over the lifetime, 2237 publications have been published within this topic receiving 26840 citations. The topic is also known as: stomy & surgical stoma.


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Patent
05 May 2005
TL;DR: In this article, the authors presented devices and methods for attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device (200) or an attachment cuff (214), within a patient's digestive tract for treatment of obesity.
Abstract: The present invention provides devices and methods for attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device (200) or an attachment cuff (214), within a patient’s digestive tract for treatment of obesity.

841 citations

Journal ArticleDOI
TL;DR: Although nonstoma patients generally fare better than do stoma patients, they also suffer from physical impairments induced by sphincter-saving procedures, which may become more prevalent as ultralow anastomosis is more frequently applied, resulting in bowel and sexual dysfunction and related psychologic distress.
Abstract: PURPOSE: The bowel and sexual function of colorectal cancer patients undergoing either sphincter-saving or sphincter-sacrificing surgical procedures may be impaired. A legitimate question is how these different surgical techniques affect the patients' quality of life. METHODS: Seventeen studies were identified that compared at least one of four aspects of patient functioning (i.e.,physical, psychologic, social, and sexual) between stoma patients and non-stoma patients. RESULTS: Although the literature does not yield entirely consistent findings, some long-term effects of surgery can be identified: 1) both patient groups are troubled by frequent or irregular bowel movements and diarrhea; 2) stoma patients report higher levels of psychologic distress than do nonstoma patients; 3) although both stoma patients and nonstoma patients report restrictions in their level of social functioning, such problems are more prevalent among patients with a colostomy; 4) sexual functioning of male and female stoma patients is consistently more impaired than that of male and female patients with intact sphincters. Results of the current review were compared with those of other, related areas. CONCLUSIONS: Although nonstoma patients generally fare better than do stoma patients, they also suffer from physical impairments induced by sphincter-saving procedures (e.g.,impaired bowel and sexual function). These impairments may become more prevalent as ultralow anastomosis is more frequently applied, resulting in bowel and sexual dysfunction and related psychologic distress. Well-designed studies are needed that examine whether quality-of-life benefits are to be gained by use of ultralow anastomosis compared with colostomy.

468 citations

Journal ArticleDOI
TL;DR: Stenting appears to be a safe and effective addition to the armamentarium of treatment options for colorectal obstructions, however, the small sample sizes of the included studies limited the validity of the findings.
Abstract: Colorectal cancer can result in malignant obstruction of the colon or rectum, through the presence of either intrinsic or extrinsic tumors. Acute or subacute bowel obstruction can lead to abdominal pain, nausea, vomiting, bowel rupture, and eventual death if left untreated. Conventional therapies for relieving malignant colorectal obstruction include surgical resection (potentially curative) or palliative colostomy. Resection is more frequently an option in patients with less advanced cancer, and is ideally carried out as a single-stage procedure, with anastomosis to restore bowel continuity. Multistage procedures may also be undertaken, with resection and stoma formation in one procedure, followed by restoration of continuity in another procedure.1 However, a significant proportion of patients receiving a staged procedure never undergo reversal of the colostomy.2 Permanent stoma creation is the standard treatment of bowel obstruction caused by nonresectable tumors, relieving the symptoms of bowel obstruction. Although it is the standard treatment modality, stoma creation is associated with high morbidity and mortality rates, particularly when undertaken under emergency conditions.1 Furthermore, stoma creation is recognized as having a highly negative impact on patients' psychosocial well-being3 and can be a burden to caregivers as well as the patient during the final months of their life. Endoscopic treatments to palliate rectal obstruction have also been developed in recent years but are not yet a standard treatment option. Medical management, including the use of opioids, anticholinergics, and antiemetics, is most commonly used in hospices and palliative care settings to assist in maintaining an acceptable quality of life in patients with terminal illness. Self-expanding metallic stents (SEMS) are expandable metallic tubes that are advanced to the site of the obstruction along a guidewire in a collapsed state, under fluoroscopic and/or endoscopic guidance. Once deployed, the stents slowly expand radially to their maximum diameter under their own force, thereby achieving patency of the obstructed anatomy. Almost all stenting procedures are carried out transanally, and are generally well tolerated by patients with only conscious sedation, or no anesthesia. The value of stent placement is as a minimally invasive alternative to open surgical techniques, such as resection or stoma creation. SEMS may be used as a definitive palliative measure or can be used as a “bridge to surgery” to allow stabilization of the patient's condition before surgery is carried out as an elective procedure at a later date. A number of stents have been designed specifically for use in the lower gastrointestinal tract and are available in a variety of lengths and diameters, so that the appropriate stent can be selected based on factors such as the length of the obstructed section of bowel and anatomic location of the obstruction. While stenting procedures are becoming a more frequent treatment modality, it is currently unclear whether stenting represents a safe and effective alternative to surgical procedures for the treatment of malignant colorectal obstructions. The aim of this review is to assess the safety and efficacy of SEMS placement for the relief of malignant colorectal obstruction in comparison to surgical procedures through a systematic review of the literature.

405 citations

Patent
20 Jun 1991
TL;DR: A gastric band adapted for laparoscopic placement around the stomach and a method for deploying the band is described in this article, which is useful for creating a small pouch with reinforced stoma in the stomach for the treatment of obesity.
Abstract: A gastric band adapted for laparoscopic placement around the stomach and a method for deploying the band is described. The band is useful for creating a small pouch with a reinforced stoma in the stomach for the treatment of obesity. A first cannula is introduced into the abdominal cavity. Following gas insufflation, a camera for observing the placement of the band is introduced into the abdominal cavity by means of the first cannula. Two additional second and third cannulas are placed within the abdomen. The gastric band, which has a head end, a tail end and a body portion therebetween, is introduced into the abdomen by means of the second cannula. As the band emerges from the second cannula, an endoscopically-guided snare passed through the third cannula grasps one end of the band and pulls it into an encircling position around the stomach. The tail end of the band is adjustably attached to the head end to form a loop around the stomach. The band is tightened until the stoma has the desired size. The band is then secured against slippage. In a preferred embodiment, the body portion of the band has an inflatable balloon on its stomach-contacting surface. Following implantation, the stoma size in the stomach may be adjusted by removal or injection of fluid into the balloon by means of an injection reservoir.

390 citations

Patent
12 Jun 1985
TL;DR: In this paper, a gastric band device for forming a stoma opening in a stomach for treatment of morbid obesity includes a flexible substantially nonextensible band portion having an expandable section that is expandable and deflatable through an injection site.
Abstract: A gastric band device for forming a stoma opening in a stomach for treatment of morbid obesity includes a flexible substantially nonextensible band portion having an expandable section that is expandable and deflatable through an injection site. After the nonextensible band portion has been positioned around the stomach to form the stoma opening, the expandable section is used to adjust the diameter of the stoma opening.

371 citations


Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023284
2022553
2021110
2020103
2019102
201886