Enteral stoma care during the COVID‐19 pandemic: practical advice

Pata, Francesco; Bondurri, Andrea; Ferrara, Francesco; Parini, Dario; Rizzo, Gianluca; Qiao, Yu; Lui, Rashid; Granero, Alvaro Garcia; Sampedro, Juan Jose Segura

doi:10.1111/codi.15279

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…The COVID-19 pandemic represents an additional challenge [ 29 , 30 ]. The extended wait times for elective surgeries and the backlog caused by the repeated lockdowns during pandemic waves is an unwanted heritage of the SARS-CoV-2 outbreak [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes

Pata

Bracchitta

D’Ambrosio³

et al. 2021

JCM

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Background: Sclerobanding is a novel technique combining rubber band ligation with 3% polidocanol foam sclerotherapy for the treatment of hemorrhoidal disease (HD). The aim of this study is to evaluate the feasibility, safety and short-term outcomes of sclerobanding in the treatment of second- and third-degree HD. Methods: A retrospective analysis of second- and third-degree HD cases from November 2017 to August 2021 was performed. Patients on anticoagulants or with other HD degrees were excluded. Follow-up was conducted at 1 month, 3 months, 6 months, 1 year and then every 12 months. Results: 97 patients with second- (20 pts; 20.6%) and third-degree (77 pts; 79.4%) HD with a mean age of 52 years (20–84; SD ± 15.5) were included. Fifty-six patients were men (57.7%) and forty-one women (42.3%). Median follow-up was 13 months (1–26 months). No intraoperative adverse events or drug-related side effects occurred. Minor complications occurred in four patients (4.1%) in the first 30 postoperative days and all resolved after conservative treatment at the 3-month follow-up visit. No mortality or readmissions were observed. Conclusions: Sclerobanding is a safe technique with a low rate of minor postoperative complications. Further studies on larger samples are necessary to establish the effectiveness and long-term outcomes of the technique.

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Section: Discussionmentioning

confidence: 99%

Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes

Pata

Bracchitta

D’Ambrosio³

et al. 2021

JCM

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“…After the emergence of COVID-19, the Japanese Society of Stoma and Continence Rehabilitation advocated the guidelines regarding consultation at ostomy clinics; consistent with the recommendation in other countries [ 10 ], they include rethinking of the indications for ostomy clinic visits and seeking alternative methods and risk assessment based on PCR testing of SARS-CoV-2, stoma site, stool form scale, patient posture, zoning of SARS-CoV-2-positive and -negative patients, and additional use of personal protective equipment such as single-use gowns, surgical masks, hair-nets, eye protection, and disposable gloves. Stoma care service at our clinic abides by the abovementioned guidelines.…”

Section: Discussionmentioning

confidence: 92%

“…Zhang et al reported that the virus is detectable in the stool of more than 50% of patients diagnosed with COVID-19 regardless of disease severity, and remains longer in the feces than in the nasopharynx and deep throat [ 9 ]. The Multidisciplinary Italian Study group for STOmas (MISSTO) recommended that follow-up and elective visits to ostomy care clinics be cancelled and/or postponed [ 10 ]. In addition to the behavior of SARS-CoV-2, these precautionary actions can place a higher burden on stoma patients [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID-19 Outbreak on Stoma Surgery and Stoma Clinic Service: A Retrospective Study at a Single Japanese Referral Hospital

Nozawa

Kawasaki

Hayashi

et al. 2022

International Journal of Clinical Practice

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Aim. The impact of the COVID-19 pandemic on medical practice has been frequently reported from Western countries, but there have been few studies in other areas, especially regarding stoma surgery and stoma care. Methods. We investigated the numbers of all operations and stoma-related surgeries at our hospital in 2019 and 2020. The cumulative numbers of consultations at our ostomy clinic and patient population stratified by the period of having a stoma were compared between these calendar years. The frequency of ostomy clinic visit by individual patients within the first year after stoma creation and stoma-related complications per consultation were also analyzed. Results. The number of elective surgeries decreased by approximately 10% from 2019 to 2020, but the numbers of stoma creation and closure procedures did not differ. The total numbers of consultations at our ostomy clinic were also similar between these years. However, the percentage of patients with a stoma for less than a year who visited our ostomy clinic increased from 49.7% in 2019 to 53.5% in 2020, whereas the visitation rate for other patients decreased. Moreover, patients with a stoma for less than a year visited the ostomy clinic more frequently in 2020 (0.42/month) than in 2019 (0.30/month, p = 0.032 ). There were fewer grade 2 or more severe peristomal complications in 2020 (11% vs 17% in 2019, p < 0.001 ) at our ostomy clinic. Conclusion. The COVID-19 outbreak led to a shift in the patient population at ostomy clinics of new stoma patients, which may have resulted in fewer peristomal complications.

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“…• Stoma management has to consider as a risk practice for infectious transmission and all caregivers have to pay attention and protect themselves with PPE [14,17]…”

Section: Bowel Anastomosis and Stoma Creationmentioning

confidence: 99%

Surgical management of oncologic patient during and after the COVID-19 outbreak: practical recommendations from the Italian society of Surgical Oncology

et al. 2020

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The recent outbreak of COVID-19 in Italy caused a limitation of the resources of the health system, which necessarily led to their rationalization in the critical phase (phase 1) and a reorganization of the system in the following phase (phase 2). The Italian Society of Oncological Surgery–SICO has drafted these practical recommendations, calibrated on the most recent scientific literature and taking into account current health regulations and common sense. Surgical activity during phase 1 and 2 should follow a dynamic model, considering architectural structures, hospital mission, organizational models. Surgical delay should not affect oncological prognosis. However, COVID-19-positive cancer patients should be postponed until the infection is cured. The patients to consider more carefully before delaying surgery are those who have completed neoadjuvant therapy, patients with high biological aggressiveness tumors or without therapeutic alternatives. The multidisciplinary discussions are fundamental for sharing clinical decisions; videoconference meetings are preferable and use of telemedicine for follow-up is recommended. Especially in phase 1, maximum effort must be made to reduce the spread of the pandemic. Prefer intra-corporeal rather than open anastomosis during laparoscopy and mechanical rather than hand-sewn anastomosis in open surgery. Consider PPE for caregivers during stoma management. Minimal invasive surgery is not discouraged, because there is little evidence for augmented risk. Specific procedures have to be followed and use of energy devices has to be limited. Training programs with COVID-19 + patients are not recommended. All staff in OR should be trained with specific courses on specific PPE use. Differentiate recommendations are presented for every district cancer. Surgical oncology during phase 2 should be guaranteed by individual and distinct protocols and pathways between cancer patients and COVID-19 + patients with resources specifically addressed to the two distinct kind of patients to limit diagnostic/therapeutic interferences or slowdowns. These recommendations are based on currently available evidence about management of oncologic patients during COVID-19 pandemic, were endorsed by the SICO Executive Board, and are considered suitable for nationwide diffusion. They will be subject to updates and revisions in case of new and relevant scientific acquisitions.

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Enteral stoma care during the COVID‐19 pandemic: practical advice

Abstract: group for STOmas (MISSTO) collaborative members are listed in the Acknowledgement.

Cited by 10 publications

References 33 publications

Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes

Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes

Impact of COVID-19 Outbreak on Stoma Surgery and Stoma Clinic Service: A Retrospective Study at a Single Japanese Referral Hospital

Surgical management of oncologic patient during and after the COVID-19 outbreak: practical recommendations from the Italian society of Surgical Oncology

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