• Advances in pediatric surgery
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• v.8 no.1
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• pp.11-15
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• 2002

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation, Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required, Sigmoid loop colostomy is preferred whenever possible.

• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.133-140
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• 2022

Background: Despite advances in surgery and intensive perioperative care, fecal peritonitis secondary to colonic perforation is associated with high rates of morbidity and mortality. This study was performed to review the outcomes of patients who underwent colonic perforation surgery and to evaluate the prognostic factors associated with mortality. Methods: A retrospective analysis was performed on 224 consecutive patients who underwent emergency colonic perforation surgery between January 2008 and May 2019. We divided the patients into survivor and non-survivor groups and compared their surgical outcomes. Results: The most common cause of colon perforation was malignancy in 54 patients (24.1%), followed by iatrogenic perforation in 41 (18.3%), stercoral perforation in 39 (17.4%), and diverticulitis in 37 (16.5%). The sigmoid colon (n=124, 55.4%) was the most common location of perforation, followed by the ascending colon, rectum, and cecum. Forty-five patients (20.1%) died within 1 month after surgery. Comparing the 179 survivors with the 45 non-survivors, the patient characteristics associated with mortality were advanced age, low systolic blood pressure, tachycardia, organ failure, high C-reactive protein, high creatinine, prolonged prothrombin time, and high lactate level. The presence of free or feculent fluid, diffuse peritonitis, and right-sided perforation were associated with mortality. In multivariate analysis, advanced age, organ failure, right-sided perforation, and diffuse peritonitis independently predicted mortality within 1 month after surgery. Conclusion: Age and organ failure were prognostic factors for mortality associated with colon perforation. Furthermore, right-sided perforation and diffuse peritonitis demonstrated a significant association with patient mortality.

• Journal of muscle and joint health
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• v.23 no.3
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• pp.197-205
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• 2016

Purpose: The purpose of this study was to conduct a comparison analysis on requirements of online continuing education requirements according to practical experience of nurses at small and medium-sized hospitals. Methods: Data had been collected with 236 nurses from May to June, 2015. The data were analyzed with the use of SPSS. Results: Among them, 45.8% participated in online continuing education. Nurses in beginning level required musculoskeletal diseases (20.9%), care for injuries and stomas (5.8%), and surgical disease and operation care (4.7%). Competent nurses required musculoskeletal diseases (19.7%), cerebrovascular diseases (9.9%), emergency care and CPR (8.5%), and medical nursing (8.5%). Skillful nurses required cerebrovascular diseases (13.9%), care for internal diseases (8.9%), and rehabilitation care (8.9%). Among the educational contents of diseases, the items that were significantly different according to practical experience were operation management ($x^2$=23.92, p<.001) and drug care ($x^2$=7.85, p=.020). Among continuing education methods, the items that were significantly different were video ($x^2$=16.81, p<.001), webtoon ($x^2$=8.96, p=.011), and test ($x^2$=10.56, p=.005). Among continuing education evaluation methods, the items that were significantly different were multiple-choices ($x^2$=9.43, p=.009) and OX ($x^2$=6.47, p=.039) based quizzes. Conclusion: Based on the study results, it is necessary to develop a differentiated continuing education program according to practical experience of nurses.