• Journal of Korean Biological Nursing Science
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• v.17 no.4
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• pp.306-314
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• 2015

Purpose: The purpose of this study was to evaluate symptoms, depression and quality of life in colorectal cancer patients who underwent stoma reversal, and to assess the factors related to their quality of life. Methods: A descriptive study was conducted on 125 colorectal cancer patients who underwent stoma reversal in a tertiary hospital in Korea. Data were collected using the Korean versions of the European Organization for Research and Treatment of Cancer-Quality of Life Core 30 and Colorectal Cancer Specific Questionnaire 38 (EORTC QLQ-C30 and CR38), and the Hospital Anxiety-Depression Scale. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and multiple regression analyses. Results: Participants experienced sexual problems, difficulties in defecation, and nausea/vomiting. About twenty-two percent of the patients were depressed and the mean score for global quality of life was $64.40{\pm}19.43$. The multiple regression showed that social and cognitive functioning, depression, and the location of the anastomosis were the important factors that made contributions to the quality of life in colorectal patients with stoma reversal. Conclusion: Our results suggest that symptom management and emotional support should be incorporated into nursing interventions to improve the quality of life in colorectal patients with stoma reversal.

• Archives of Plastic Surgery
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• v.46 no.3
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• pp.277-281
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• 2019

Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for recto-vaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated recto-vaginal septum. It can function as a well-vascularized tissue plug to promote healing.