Zhu YL, Li R, Cheng YG, Wang YF. Perioperative management of postoperative sigmoid colon cancer complicated by a large abdominal wall defect: A case report. World J Clin Oncol 2024; 15(10): 1333-1341 [PMID: 39473861 DOI: 10.5306/wjco.v15.i10.1333]
Corresponding Author of This Article
Ya-Fei Wang, DSc, PhD, Lecturer, Department of Nursing, Anhui Medical College, No. 632 Furong Road, Shushan District, Hefei 230601, Anhui Province, China. 82716925@qq.com
Research Domain of This Article
Nursing
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Oct 24, 2024; 15(10): 1333-1341 Published online Oct 24, 2024. doi: 10.5306/wjco.v15.i10.1333
Perioperative management of postoperative sigmoid colon cancer complicated by a large abdominal wall defect: A case report
Yan-Ling Zhu, Rui Li, Yuan-Guang Cheng, Ya-Fei Wang
Yan-Ling Zhu, Ya-Fei Wang, Department of Nursing, Anhui Medical College, Hefei 230601, Anhui Province, China
Rui Li, Department of Gastrointestinal Surgery, Hefei First People’s Hospital, Hefei 230061, Anhui Province, China
Yuan-Guang Cheng, Department of Gastrointestinal Surgery, Anhui Medical University (the Third Affiliated Hospital), Hefei 230061, Anhui Province, China
Co-corresponding authors: Yuan-Guang Cheng and Ya-Fei Wang.
Author contributions: Zhu YL and Wang YF designed the outline of this article; Zhu YL performed the writing; Wang YF and Cheng YG made critical revision of the manuscript for important intellectual content; Cheng YG and Li R performed clinical data collection and prepared the figures. All authors contributed to this manuscript. Cheng YG is very familiar with the patient's condition, serving as the attending physician and fully involved in the surgery and treatment process. He provided important suggestions and supervision for the nursing and treatment process of patients. Cheng YG participated in the design of the paper, and performed clinical data collection and prepared the figures. Cheng YG and Wang YF jointly conducted focused supervision on the entire paper. Given his contribution to the article and with the consent of all authors.
Supported byYouth Project of Anhui Provincial Health Commission T, No. AHWJ2023A30225.
Informed consent statement: This study was approved by the Hefei First People’s Hospital, and the participant provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Fei Wang, DSc, PhD, Lecturer, Department of Nursing, Anhui Medical College, No. 632 Furong Road, Shushan District, Hefei 230601, Anhui Province, China. 82716925@qq.com
Received: March 25, 2024 Revised: August 25, 2024 Accepted: August 29, 2024 Published online: October 24, 2024 Processing time: 187 Days and 13.9 Hours
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.
Core Tip: Multiple intestinal fistulas are high-flow fistulas, which may lead to severe water and electrolyte disorder and malnutrition in patients. After nutritional support treatment, care of the abdominal wall defect and intestinal fistula, continuous irrigation of abdominal drainage tube and low negative pressure drainage and other active treatment and nursing measures, the patient's malnutrition, infection and other conditions were improved, which created the opportunity for surgery, so that the surgery was finally successfully operated.
