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OBJECTIVE: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. METHOD: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. RESULTS: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). CONCLUSIONS: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.

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ABSTRACT Objective: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. Method: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. Results: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). Conclusions: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.

RESUMO Objetivo: elaborar o perfil epidemiológico dos pacientes estomizados atendidos no Serviço de Atenção à Saúde da Pessoa Ostomizada de Juiz de Fora e região (SASPO/JF) e quantificar tanto as patologias que levaram à confecção, quanto as complicações presentes nas estomias. Método: realizado estudo retrospectivo com análise de 496 prontuários de pacientes cadastrados no SASPO/JF ao longo de 30 anos e que permaneciam em atendimento no serviço em junho de 2018. Foram consideradas as seguintes variáveis: idade, sexo, patologia que levou à confecção do estoma, tipo, caráter temporal, localização e complicações das estomias. Resultados: 53,43% dos pacientes eram do sexo masculino e 46,57% do sexo feminino. A média de idade entre os homens foi de 56,24 anos e entre as mulheres foi de 58,40 anos. Oito pacientes apresentaram dois tipos de estomias simultaneamente e o total de 504 estomias foi distribuído da seguinte forma: 340 colostomias (67,46%), 117 ileostomias (23,21%) e 47 urostomias (9,33%). Além disso, 47,65% das colostomias e 76,92% das ileostomias foram temporárias, enquanto todas as urostomias foram permanentes. Em 70,24% dos casos, o motivo para confecção do estoma foi a neoplasia maligna. Foram encontrados 277 estomas com uma ou mais complicações (54,96%). Conclusão: as estomias predominaram em pacientes com mais de 50 anos e o principal diagnóstico que levou à confecção dos estomas foi a neoplasia maligna. As ileostomias apresentaram maior percentual de complicações do que as colostomias e urostomias e, para todos os tipos de estomas, a complicação mais frequente foi a dermatite.

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The Ostomy Adjustment Inventory-23 (OAI-23) was developed in English to measure the social and psychological adaptation of individuals who underwent ostomy surgeries. PURPOSE: The aim of the current study was to culturally adapt and test the measurement properties of a Brazilian Portuguese adapted version of the OAI-23. METHODS: The original version of the OAI-23 was composed of 23 questions distributed into the following 4 factors: acceptance, anxiety/preoccupation, social engagement, and anger. The OAI-23 was translated into Portuguese, reviewed by a committee of expert reviewers, pretested on a focus group, and back-translated. Using convenience sampling methods, patients who were treated at specialized health centers located in different parts of Brazil were invited to complete a demographic and health history questionnaire, the Janis and Field Self-Esteem Scale, and the adapted version of OAI-23 to assess its reliability, convergent construct validity, and discriminant construct validity. RESULTS: A total of 191 patients with a mean age of 58.9 years (SD = 14.7) (74.1% with colostomies, 19.6% with ileostomies, and 6.3% with urostomies) participated in the study. The Brazilian Portuguese adapted version of the OAI-23 had a Cronbach's alpha coefficient of 0.846 and an intra-class correlation coefficient of 0.903 (P < .001). Significant correlations between OAI-23 scores and self-esteem scale scores confirmed the convergent construct validity, and the instrument was able to discriminate patients' adjustment according to age. CONCLUSION: The adapted version of the OAI-23 proved to be reliable and valid for use in Brazil; this represents the first instrument capable of assessing psychosocial adaptation of patients with stomas in that country.

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INTRODUCCIÓN: a. Cuadro clínico: En las cirugías de colostomía e ileostomía, la función intestinal normal se interrumpe y el contenido intestinal pasa a través de la pared abdominal al exterior por medio de una apertura llamada ostoma u ostomía hacia un dispositivo (bolsa), que debe vaciarse periódicamente. Este enfoque terapéutico puede ser temporal o permanente y compromete severamente la calidad de vida y funcionamiento del individuo. Existen muchas complicaciones asociadas al uso de una ostomía, siendo las más importantes la irritación de la zona del ostoma y la fuga de secreciones fuera de la bolsa al exterior. b. Descripción de la tecnología: La pasta de ostomía es un dispositivo médico que se usa como una masilla para rellenar contornos desiguales de la piel ayudando a crear una superficie más plana y de esta forma mejorar la adhesión de la bolsa de ostomía. Este sellado evitaría la fuga de contenidos intestinales fuera de la bolsa. OBJETIVO: Evaluar la eficacia y seguridad, así como documentos relacionados a la cobertura de pasta para cuidado de ostomía. METODOLOGÍA: Se realizó una búsqueda en las principales bases de datos bibliográficas: MEDLINE, LILACS, COCHRANE, así como en buscadores genéricos de Internet incluyendo Google Académico y TRIPDATABASE. Adicionalmente, se hizo una búsqueda dentro de la información generada por las principales instituciones internacionales de gastroenterología, urología y cirugía; y agencias de tecnologías sanitarias que realizan revisiones sistemáticas (RS), evaluación de tecnologías sanitarias (ETS) y guías de práctica clínica (GPC). RESULTADOS: Se seleccionaron una RS y tres GPC con respecto a pasta para cuidado de ostomía. No se encontraron ETS, ni evaluaciones económicas de la región. CONCLUSIONES: La evidencia con respecto a la pasta para cuidado de ostomías es escasa y de baja calidad metodológica. No se encontraron estudios comparativos que evaluaran la pasta para cuidado de ostomía frente a otra tecnología para la prevención de fuga de secreciones fuera de la bolsa de ostomía. Sin embargo, las tres GPC coinciden en considerarla una opción válida para el manejo de pacientes con ostomías, sin establecer una preferencia por sobre otra tecnología.

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INTRODUCCION: Las ostomías tienen diferente localización según el procedimiento quirúrgico. En este caso la colostomía es intervención quirúrgica para comunicar el intestino grueso con la pared abdominal. La ileostomía comunica al intestino delgado hacia la pared abdominal, están indicadas en diversos procedimientos y situaciones patológicas del intestino. CASO CLINICO: Paciente masculino de 70 años de edad, presento alza térmica, astenia, dolor abdominal y pélvico, melenas, ruidos hidroaéreos disminuidos, depresible, doloroso a la palpación, timpánico a la percusión, con bolsa de colostomía en flanco izquierdo y de ileostomía en hipocondrio derecho, fístula colocutánea en zona suprapúbica de aproximadamente 2 cm de diámetro, extremidades de tono y fuerza muscular disminuida, marcha inestable, deambula con ayuda. Antecedentes patológicos: hipertensión arterial, trastorno depresivo y esquizofrenia, vólvulo intestinal y deshidratación. EVOLUCIÓN: Paciente con antecedente de vólvulo, se realiza laparotomía exploratoria, sigmoidectomía, lavado de cavidad abdominal y colostomía. Un año después, se realiza cierre de colostomía, adherenciolisis, apendicectomía, resección intestinal con anastomosis latero lateral ileocecal, reconstrucción del tránsito mediante anastomosis colorectal termino-terminal; luego de dos meses reingresa por dehiscencia de anastomosis colorectal, se realiza colostomía e ileostomía de descarga, es hospitalizado por un mes; reingresa dos semanas después con evidencia de fístula colocutánea, dado de alta luego de 31 días de hospitalización, con cierre espontáneo de fístula y en regular estado general es trasladado a asilo de ancianos. CONCLUSIÓN: Se trata de un caso de colostomía más ileostomía y fístula abdominal, paciente con complicaciones y reingresos frecuentes. El abordaje de enfermería en el manejo de ostomías es fortalecer los cuidados y conseguir en el paciente el autocuidado y la reinserción a su vida cotidiana.(AU)

BACKGROUND: The colostomy is a surgical procedure to communicate the large intestine with the abdominal wall. The ileostomy communicates to the small intestine towards the abdominal wall; they are indicated in diverse procedures and pathological situations of the intestine. CASE REPORT: A 70-year-old male patient with fever, asthenia, abdominal and pelvic pain, melena, decreased bowel sounds, painful palpation, tympanic noise at percussion, left flank colostomy and ileostomy in right hypochondrium, colocutaneous a fistula in suprapubic area of approximately 2 cm diameter, limbs of tone and decrease muscle strength, unsteady gait, wandering with help, depressive. Pathological antecedents: arterial hypertension, depressive disorder and schizophrenia, intestinal volvulus and dehydration. EVOLUTION: Patient with history of volvulus, exploratory laparotomy, sigmoidectomy, lavage of the abdominal cavity and colostomy. One year later the colostomy was closed, adherenciolysis, appendectomy, intestinal resection with lateral ileocecal lateral anastomosis and reconstruction of the transit through a termo-termino colorectal anastomosis; After two months of re-entry due to dehiscence of colorectal anastomosis, colostomy and ileostomy discharge, he was hospitalized for a month; The re-entry two weeks later with evidence of postoperative fistula, discharged after 31 days of hospitalization, with spontaneous closure of the fistula and in general regular state is transferred to the nursing home. CONCLUSION: It is a case of colostomy plus ileostomy and abdominal fistula in patient with frequent complications and re-entries. The approach of nursing in the management of ostomies is to strengthen the care, to obtain and teach in the patient the self-care and the reintegration into their daily life. (AU)

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Resumo Objetivos Objetivou-se avaliar a qualidade de vida de pessoas com estomias intestinais de eliminação e verificar sua associação com características sociodemográficas e clínicas. Métodos Trata-se de estudo descritivo e transversal realizado com 96 pessoas cadastradas em um Programa de estomizados, utilizando o City of Hope - Quality of Life- Ostomy Questionnary. Resultados O escore médio de QV total deste estudo foi 6,2 ± 2,8. O maior escore médio foi encontrado no domínio Bem-estar espiritual 7,5 (±1,9) e o menor no domínio Bem-estar social 5,6 (±2,1). As características sociodemográficas (renda per capita, escolaridade, religião) e as características clínicas (permanência e adaptação à estomia, tempo de estomizado para sentir-se confortável, dificuldade para o autocuidado e limitação para realização de atividades diárias) associaram-se a qualidade de vida total e seus domínios (p <0,05). Conclusão As estomias intestinais de eliminação interferem na qualidade de vida, principalmente nos âmbitos físico e social.

Abstract Objectives To evaluate the quality of life of people with intestinal stomas and verify its association with sociodemographic and clinical characteristics. Methods A cross-sectional descriptive study was carried out with 96 people registered in an ostomy program, with the use of the City of Hope-Quality of Life-Ostomy Questionnaire. Results The mean score of total QoL in this study was 6.2± 2.8. The highest mean score was found in the spiritual well-being dimension 7.5 (±1.9) and the lowest in the social well-being dimension 5.6 (±2.1). Sociodemographic characteristics (per capita income, education level, religion) and clinical characteristics (length of use and adaptation to the stoma, length of time needed for ostomized people to feel comfortable, difficulty with self-care, and limitation to perform activities of daily living) were associated with total quality of life and its dimensions (p <0.05). Conclusion Intestinal stomas interfere with quality of life, especially in physical and social dimensions.

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OBJECTIVE: To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure. MATERIAL AND METHODS: We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression. RESULTS: The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35 %, idiopathic etiology in 29 % and prior hypospadia repair in 18 %. Postoperative failure occurred in 3 patients, with a final success of 82.4 %. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21). CONCLUSIONS: The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis.

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Objective To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure. Material and methods We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression. Results The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35%, idiopathic etiology in 29% and prior hypospadia repair in 18%. Postoperative failure occurred in 3 patients, with a final success of 82.4%. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21). Conclusions The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis. .

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