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Ostomy Creation for Palliative Care of Patients With Nonresectable Colorectal Cancer and Bowel Obstruction

Pickard, Colette; Thomas, Rachel; Robertson, Isabell; Macdonald, Angus

Journal of Wound, Ostomy and Continence Nursing: May/June 2018 - Volume 45 - Issue 3 - p 239–241
doi: 10.1097/WON.0000000000000424
Ostomy Care: BRIEF RESEARCH COMMUNICATION

PURPOSE: The purpose of this study was to review our experience with palliative ostomy surgery in patients with bowel obstruction and advanced stage colorectal cancer.

DESIGN: A descriptive, retrospective review of data from a prospectively collected clinical database.

SUBJECTS AND SETTING: The sample comprised 86 patients (55 male) who underwent palliative surgery between October 1998 and January 2009.

METHODS: All patients undergoing palliative stoma formation without resection for colorectal carcinoma were identified from a prospectively compiled colorectal cancer database. Patients having colorectal stent placement and bypass surgery were excluded from analysis.

RESULTS: The median age at surgery was 71 years (interquartile range, 65-79 years). The median survival following ostomy creation was 103 days (interquartile range, 19-263 days). Sixty-nine percent of participants (n = 59) survived 30 days and 18% (n=16) survived 12 months.

CONCLUSIONS: Our results confirm that patients undergoing palliative stoma formation have limited life expectancy. Nevertheless, these findings are encouraging when compared to the anticipated outcomes of untreated bowel obstruction.

Colette Pickard, Department of Surgery, Monklands District General Hospital, Airdrie, Lanarkshire, Scotland.

Rachel Thomas, MD, FRCS, Department of Surgery, Monklands District General Hospital, Airdrie, Lanarkshire, Scotland.

Isabell Robertson, BSc, RGN, Department of Surgery, Monklands District General Hospital, Airdrie, Lanarkshire, Scotland.

Angus Macdonald, MD, FRCS, Honorary Clinical Associate Professor, University of Glasgow MVLS and Department of Surgery, Monklands District General Hospital, Airdrie, Lanarkshire, Scotland.

Correspondence: Angus Macdonald, MD, FRCS, Department of Surgery, Monklands Hospital, Monkscourt Ave, Airdrie ML6OJS, Scotland (angus.macdonald@lanarkshire.scot.nhs.uk).

Colette Pickard reviewed the data and wrote the article. Rachel Thomas performed the original review of the data. Isabell Robertson collected the data and maintained the stoma database. Angus Macdonald was the surgeon who performed the operations reported in this article.

© 2018 by the Wound, Ostomy and Continence Nurses Society.