Perioperative management of postoperative sigmoid colon cancer complicated by a large abdominal wall defect: A case report.

IF 2.6 Q3 ONCOLOGY

World journal of clinical oncology Pub Date : 2024-10-24 DOI:10.5306/wjco.v15.i10.1333

Yan-Ling Zhu, Rui Li, Yuan-Guang Cheng, Ya-Fei Wang

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引用次数: 0

Abstract

Background: Large abdominal wall defect (LAWD) measures > 20 cm in width. LAWD can easily lead to intestinal necrosis, peritonitis, other complications, and even multiple organ dysfunction syndrome. Multiple intestinal fistulas are high-flow fistulas that can cause severe water-electrolyte imbalance and malnutrition, as well as inflammation, high metabolic status, and chronic intestinal failure caused by intestinal fluid corrosion in tissues around the orifice fistulas.

Case summary: This article summarizes the nursing experience of a patient with sigmoid carcinoma who has LAWD with multiple intestinal fistula due to repeated operations for postoperative complications. The key points of care: Scientific assessment of nutritional status, dynamic adjustment of nutritional support programmes, comprehensive adoption of enteral nutrition, parenteral nutrition and combined nutrition of enteral and parenteral; taking good care of abdominal wall defects and intestinal fistulas; continuous flushing of the abdominal drainage tube and low negative pressure drainage; prevention of venous thrombosis; strengthening of physical exercise; implementation of positive psychological interventions.

Conclusion: After more than 7 months of careful care, the patient's physical fitness has been well recovered, local inflammation is well controlled, which wins the opportunity for the operation, and the postoperative recovery is good.

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乙状结肠癌术后并发巨大腹壁缺损的围手术期处理：病例报告。

背景：大腹壁缺损（LAWD）的宽度大于 20 厘米。腹壁缺损容易导致肠坏死、腹膜炎、其他并发症，甚至多器官功能障碍综合征。多发性肠瘘属于高流量肠瘘，可引起严重的水电解质失衡和营养不良，同时由于肠液腐蚀肠瘘口周围组织，导致炎症、高代谢状态和慢性肠功能衰竭。病例摘要：本文总结了一名乙状结肠癌患者因术后并发症反复手术导致LAWD合并多发性肠瘘的护理经验。护理要点科学评估营养状况，动态调整营养支持方案，综合采用肠内营养、肠外营养及肠内、肠外联合营养；做好腹壁缺损、肠瘘的护理；持续冲洗腹腔引流管，低负压引流；预防静脉血栓形成；加强体育锻炼；实施积极的心理干预：经过7个多月的精心护理，患者体质恢复良好，局部炎症控制良好，为手术赢得了机会，术后恢复良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World journal of clinical oncology ONCOLOGY-

自引率

0.00%

发文量

585

期刊介绍： The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.