Many risk factors cause infection in the surgical site. This study examined the bactericidal effect of oxidized electrolyte water (EOW) as an antiseptic against decreasing levels of peristomal germ density in children colostomy areas, selected experimental studies of phase 2 study. This study was conducted in pediatric patients with a colostomy who were going to undergo stoma lid surgery to prove the bactericidal effect of EOW on the density of pediatric stoma area. Frequency distribution of the number of pre-antiseptic bacteria of the research sample was 30 samples. There were 1 preparation (3.3%) with 0-1,000 bacteria, 4 preparations (13.3%) with 1,000-10,000 bacteria, and 25 preparations (83.3%) with bacteria >10,000. The results of the examination showed the number of post-antiseptic germs on 27 preparations (90%) with the number of germs of 0-1,000, 0 preparations (0%) with the number of germs of 1,000-10,000, and 3 preparations (10%) with the number of germs >10,000. This test obtained a significant difference between the 2 groups (p = 0.001), showing a significant difference between the pre-antiseptic EOW and post-antiseptic EOW groups. EOW can significantly reduce the level of skin germ density in children with colostomy peristomal.

As one of the most frequent malignancies in the world’s population, colorectal cancer is also associated with its complications (perforation, obstruction and bleeding). Their incidence is common (2.6-50%), but synchronous occurrence of two of them in a patient is a rare condition and it is reported in small series or as a case report in the literature. We present a case of the descending colon cancer in a female patient that presented with perforation on tumor site with consecutive retroperitoneal and lumbar abscess and simultaneous presentation of large bowel obstruction. The patient was admitted and operated the same day, the abscess was opened and drained and bowel resection was performed with colostomy creation. The postoperative recovery was uneventful and the patient was discharged on postoperative day 10. Due to the high morbidity/mortality in cases of colon cancer emergencies, Hartman’s procedure is often a reasonable option. Timely diagnosis of the colon cancer can reduce the complication rate of the disease worldwide. J Med Cases. 2021;12(6):248-250 doi: https://doi.org/10.14740/jmc3684

OBJETIVO:Describir el manejo quirúrgico realizado para la reconstrucción génitoperineal (RGP) en pacientes con secuelas de Gangrena de Fournier (GF). MATERIAL Y MÉTODOS:Corresponde a una serie de casos retrospectiva de pacientes con secuelas de GF a los que se les realizó RGP entre el 2011 al 2019. Se realizó un análisis descriptivo con las variables de técnica quirúrgica, edad, sexo, comorbilidades, subunidades anatómicas afectadas, origen anatómico de la gangrena de fournier, número de procedimientos quirúrgicos, procedimiento de colostomía, terapia de presión negativa, Flexi-Seal®, bacterias aisladas, duración de estancia hospitalaria, tipo de procedimientos reconstructivos y complicaciones. RESULTADOS:Se realizó RGP a 43 pacientes (81,1% masculinos), con un promedio de edad de 59,1 (17–86 años). 72,7% eran diabéticos. El número de subunidades involucradas se asocia directamente y significativamente en relación al número de intervenciones quirúrgicas. Las técnicas utilizadas para la reconstrucción en orden de frecuencia fueron: colgajos (23%), cierre parcial más injerto dermoepidérmico de grosor parcial (IPP) (20%), cierre parcial (16%) e IPP (16%), cierre por segunda intención (10%), colgajo más IPP (7%) y cierre parcial para cierre por segunda intención de zona restante (5%).DISCUSIÓN:La elección de reconstrucción se basa en las características del defecto, es decir, el tamaño, la ubicación y profundidad, así como la disponibilidad de tejido local. De preferencia optar por cierres primarios sin tensión, seguido de colgajos y de IPP.CONCLUSIÓN: La RGP es un desafío para el cirujano plástico. Las técnicas descritas han demostrado ser seguras y reproducibles para el tratamiento quirúrgico de la Gangrena de Fournier.

Introduction. Desmoplastic small round-cell tumours (DSRCT) are primarily intra-abdominal soft tissue sarcomas that are extremely rare and aggressive with a rapidly deteriorating clinical course and poor outcome despite therapy. It belongs to the family of small round blue-cell tumours, symptoms of the disease are non-specific and metastasis is often present at diagnosis. Objective. This report presents a typical case of an intra-abdominal DSRCT while highlighting how challenging the diagnosis can be in resource-poor settings and best-practice in the management of its attendant complications. Case presentation. This is a case 10-year-old boy who presented with a two-month history of weight loss and a two-week history of colicky abdominal pain, abdominal distension and vomiting and loss of appetite. He was pale, had left mandibular lymphadenopathy with a distended abdomen and ascites. A palpable mass was occluding ~80% of his rectal lumen. CT scan showed intra-abdominal masses in the rectovesical pouch and hepatic flexure with abdominopelvic lymphadenopathy Patient was worked up for exploratory laparotomy, colostomy placement and tumor biopsy, with the subsequent histology and immunohistochemistry a diagnosis of DSRCT was made. The patient developed moderate anaemia, acute kidney injury, hypertension and anarsarca while on admission; these were successfully managed with blood transfusions, intravenous fluids and drugs subsequently. He had a re-exploration for fecal disimpaction and adhesiolysis due to persistent intestinal obstruction. Patient was discharged 15 days after admissionin a stable clinical state. Conclusion. Desmoplastic round-cell tumour (DSRCT) primarily occurr within the abdomen, it is capable of mimicking the symptomatology of other intra-abdominal malignancies and a high index of suspicion is requisite to make a diagnosis especially in resource-poor settings with swift implementation of treatment modalities necessary to halt disease progress.

Cancer patients face a lot of psychological and social problems apart from physical problems from the time of diagnosis. The problems arise out of biological, psychological and situational factors affects the quality of life (QOL) of a cancer patient which requires cancer care. Cancer care is a multidisciplinary approach, is a teamwork which involves oncologists, oncology nurses, and social workers, etc., Social work in oncology settings is an essential component of comprehensive cancer care dealing with psychosocial, emotional and economical aspects of cancer. The present paper examines the empirical evidence and illustrates an evidence-based case study, of an unmarried adult male detected with carcinoma rectum with a permanent colostomy and social work interventions at pre, during and post-treatment and client's quality of life. Keywords: Social Worker, Cancer, Quality of life, Social work Interventions

Introduction One distinct disadvantage of Paul Mikulicz double-barreled colostomy is the need to apply an enterotome to the stoma for several days to crush the intervening spur before the double-barreled colostomy is closed. A new modification of the old technique was applied to omit the usage of the enterotome and avoid the riskiest complications of colostomy closure. Aim The aim of this study was to evaluate the efficacy and safety of this new technique, staged stapling closure of the double-barreled stomas, to publicize its use for all temporary stomas. Patients and methods Being a new technique, only 20 patients were included in this study. They all were old patients of both sexes. This new technique is accomplished in three stages: stage I is to perform the original double-barreled enterostomy in its native manner, stage II: 1 week later after in the outpatient clinic without the need for anesthesia, sterilization, or bowel preparation, where the spur between the two limbs of the enterostomy is divided using GIA stapler, and stage III: where 2 weeks later, under local or spinal anesthesia, extraperitoneal closure of the stoma was done with double-layer sutures. Results This study was carried out between November 2018 and January 2020 on 20 patients, aged 64–86 years, comprising 12 males and eight females. Only one (5/%) case was complicated with leakage and wound gaping. She had another trial of closure 2 weeks later, which succeeded. At the end, all patients were discharged home, with open bowel, normal defecation, and surgically stable. There was no mortality throughout our study. Conclusion Extraperitoneal staged stapling closure of the double-barreled enterostomy is a safe and easy technique to close temporary stomas with no need for another laparotomy and without the risk of peritonitis or obstruction.

Background Intestinal viability is crucial before commencement of any anastomoses or establishment of stomas after resection of the gut for any surgical reason, and depending on the clinical sense and subjective methods alone may result in disastrous results and complications affecting the outcomes of the surgical procedures. There are many techniques available nowadays for assessing bowel viability, but most of them are technically demanding and not usually available in the operating theater, besides the cost of many of them, which may represent another added burden. For all the aforementioned reasons, the wireless pulse oximeter (PO) has emerged as a possible new method which can aid in assessment of bowel viability during surgeries with the advantages of availability, low cost, and simple rapid way of gut viability assessment. Purpose The aim of this study was to evaluate the capability of the wireless PO in discrimination between viable and nonviable intestine intraoperatively before establishment of stomas or intestinal anastomoses. Study design This was a prospective study that included 40 patients who were evaluated intraoperatively by the wireless PO to assess the viability of the proximal and distal ends of the intestine. The intestinal viability in the first 10 patients was also evaluated by the fluorescein dye in addition to the PO. Here, fluorescein was used as a well-established method to validate the new technique of the PO. All the readings were recorded, and patients were followed up for 2 weeks postoperatively to detect any complications related to intestinal ischemia. Results Three cases were complicated: two cases of failed anastomosis with leakage and the third case was ischemic end colostomy stoma. The mean values of PO readings in the noncomplicated group (37 cases) were 95.65 and 96.32% in the proximal and distal segments, respectively, whereas in the complicated group (three cases), mean values were 89 and 87% in the proximal and distal segments, respectively. Conclusion The PO device is safe, portable, and nonsophisticated, which can be used easily by surgeons in assessment of bowel viability during surgery. It takes less time to assess the intestinal viability and is very cost-effective, as one device can be used in multiple patients.

SamenvattingEen 62-jarige vrouw onderging een double barreled wet colostomy (DBWC) na een bekkenexenteratie. De DBWC is een relatief onbekende ingreep, waarbij een colostoma wordt aangelegd met twee openingen, waardoor urine en ontlasting via gescheiden compartimenten naar buiten worden geleid. Het doel van dit artikel is de DBWC te vergelijken met een gescheiden urostoma en colostoma aan de hand van een casus en een review van de beschikbare literatuur. Er werden drie retrospectieve studies gevonden die een DWBC vergeleken met een gescheiden uro- en colostoma, met in totaal 267 patiënten. Daaruit bleek geen verhoogde mortaliteit en morbiditeit bij een DBWC ten opzichte van een gescheiden urinestoma en colostoma. De conclusie luidt dat een DBWC kan worden overwogen na een bekkenexenteratie.

Objective To explore the effects of power feedback method on knowledge, attitude, practice and quality of life in patients with permanent colostomy for rectal cancer. Methods Totally 110 patients receiving permanent colostomy for rectal cancer in the Second People's Hospital of Lianyungang from April 2018 to March 2019 were selected by convenient sampling. The 55 patients admitted between April and September 2018 were divided into control group, while the 55 patients admitted from October 2018 to March 2019 were divided into observation group. Patients in the control group learned the knowledge about colostomy care by presentation to group, while patients in the observation group received interventions based on the power feedback method. Colostomy Patient Colostomy Knowledge Attitude and Practice Scale (CPCKAPS) and City of Hope-Quality of life-Ostomy Questionnaire (COH-QOL-OQ) were used to compare the effects of intervention. Results The CPCKAPS scores in the observation group were higher than those in the control group after intervention, and the difference was statistically significant (P 0.05) . Conclusions The power feedback method can improve the level of knowledge, attitude and practice of patients with permanent colostomy for rectal cancer, and further large-scale and long-term research is needed to explore its effects on the quality of life of patients. Key words: Rectal neoplasms; Power feedback method; Colostomy; Knowledge, attitude and practice; Quality of life

Objective To explore the current needs for the personnel, service mode and service duration of continuous nursing services in patients with permanent colostomy and provide support for developing continuous nursing services. Methods Totally 120 patients with permanent colostomy who were discharged after surgery and attended outpatient services in a ClassⅢ Grade A general hospital in Shandong province between January and December 2018 were selected by convenient sampling and investigated using a self-designed questionnaire for continuous nursing needs in patients with permanent colostomy. Results The top 3 needs for continuing nursing services were telephone, outpatient service, and home follow-up. The top 3 needs for service personnel were interdisciplinary teams, doctors, and stoma therapists. The most demanding service duration after discharge was 3 to 6 months. The most demanding service time was from 18∶00 to 20∶00. In terms of service frequency, the telephone follow-up was once a week or once every two weeks; the home follow-up was once every 2 weeks; and the outpatient follow-up was once every 2 weeks or once a month. Conclusions Clinical medical staff should explore more optimized continuous nursing service plans and promote the establishment of a high-quality and efficient continuous nursing service system based on the main needs of patients with permanent colostomy for continuous nursing services. Key words: Colostomy; Continuous nursing; Nursing need; Investigation

This article summarized the assessment tools of quality of life and psychology, psychological factors on the quality of life of patients with enterostomy and psychological nursing measures to improve the quality of life of patients with enterostomy. Then further clarified the significance of psychological nursing and health education to improve the quality of life of patients with enterostomy. It is suggested that appropriate intervention methods should be adopted according to the different psychological characteristics of stoma patients, and comprehensive health education and personalized psychological nursing should be carried out in stages in order to reduce the level of negative psychological factors and improve the level of positive psychological factors of patients, so as to achieve the goal of improving the quality of life of patients. Key words: Colon; Quality of life; Colostomy; Psychological factors

Objective To analyze the risk factors for postoperative enterocutaneous fistula after inguinal hernia free tension repair. Methods The retrospective case-control study was conducted. The clinical data of 679 patients who underwent inguinal hernia free tension repair between January 2015 and September 2018 in Beijing Chao-Yang Hospital of Capital Medical University were collected. There were 646 males and 33 females, aged (65±12)years, with a range from 28 to 94 years. Observation indicators: (1) surgical situations of inguinal hernia free tension repair; (2) follow-up; (3) enterocutaneous fistula and its treatment; (4) risk factors for postoperative enterocutaneous fistula after inguinal hernia free tension repair. Follow-up by outpatient examination and telephone interview was performed to detect the postoperative enterocutaneous fistula up to June 2019. Measurement data with normal distribution were represented as Mean±SD. Count data were described as absolute numbers. Univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model, respectively. Results (1) Surgical situations of inguinal hernia free tension repair: 679 patients underwent inguinal hernia free tension repair. Of 679 patients, 215 underwent plug repair or mesh-plug repair, including 9 cases undergoing Plug repair only, 50 undergoing Millikan procedure, and 156 undergoing Rutkow procedure, other 464 underwent non-plug surgery, including 181 undergoing Lichtenstein procedure, 53 undergoing transinguinal preperitoneal hernia repair (TIPP), and 230 undergoing transabdominal preperitoneal patch repair (TAPP) and total extraperitoneal inguinal hernia repair (TEP). Polypropylene mesh or plug were used in all 679 cases. The operation time and volume of intraoperative blood loss were (61±14)minutes and (10±7)mL. There were 580 of 679 patients treated with prophylactic antibiotics. (2) Follow-up: 679 patients were followed up for 15-86 months, with a median time of 51 months. There were 12 male patients with postoperative enterocutaneous fistula, aged (69±8)years, with a range from 57 to 79 years, twelve patients with enterocutaneous fistula developed symptoms within the time of (42±25)months. (3) Enterocutaneous fistula and its treatment: of 12 patients with enterocutaneous fistula, 11 underwent plug repair or mesh-plug repair, and 1 undergwent TAPP(enterocutaneous fistula secondary to invasion of preperitoneal patch to intestines). The fistulas were located at inguinal region, with a diameter of 0.5-1.0 cm. In the 12 patients, of the 5 patients with sigmoid fistula, 4 underwent intestinal resection around the fistula, 1 underwent distal bowel closure and proximal colostomy. Six patients had enteric fistula, including 5 secondary to invasion of plug to intestines and 1 due to preperitoneal patch in TAPP, and they underwent resection of intestines with fistula combined with side-to-side intestial anastomosis, or laparoscopic suture of all layers and seromuscular layer of enterocutaneous fistula. One patient with intestinal and vesical fistulas underwent resection of intestines with fistula, and had sutured and embeded them with 3-0 absorbable strings. Operation time of 12 patients was (126±40)minutes. Five patients received debridement and drainage for reoperation. Duration of hospital stay of 12 patients was (37±11)days. (4) Risk factors for postoperative enterocutaneous fistula after inguinal hernia free tension repair: results of univariate analysis showed that surgical method was associated factor for postoperative enterocutaneous fistula after inguinal hernia free tension repair (χ2=17.601, P<0.05). Results of multivariate analysis showed that plug repair or mesh-plug repair was an independent risk factor for postoperative enterocutaneous fistula after inguinal hernia free tension repair (odds ratio=32.279, 95% confidence interval: 4.027-258.735, P<0.05). Conclusion The plug repair or mesh-plug repair is an independent risk factor for postoperative enterocutaneous fistula after inguinal hernia free tension repair. Key words: Hernia; Inguinal hernia; Tension free repair; Plug; Enterocutaneous fistula; Risk factors

Objective To investigate the effect of mind map on the cancer-related fatigue and self-management efficacy in patients with colonic colostomy. Methods A total of 122 cases of colon cancer colostomy admitted to our hospital from March, 2015 to March, 2019 were selected; and 61 patients who underwent routine care were set as the control group, and the other 61 cases who were intervened by mind map an observation groups. The cancer-related fatigue, self-management efficacy, and quality of life were compared between the two groups before and after the treatment. Results After 6 months of nursing, the scores of physical fatigue, emotional fatigue, cognitive fatigue, and total fatigue were (16.92±1.04), (8.79±0.78), (7.98±0.71), and (33.20±1.08) in the observation group, which were lower than those in the control group (all P<0.05); the scores of positive attitude, self-decompression, self-decision, and self-efficacy were (41.53±1.74) , (29.53±1.04) , (11.74±0.82) , and (79.81±2.49) in the observation group, which were higher than those in the control group (all P<0.05); the physical, mental, environmental, and spiritual scores and the scores of independence and social relations were (84.43±8.37), (86.63±8.41), (85.25±7.24), (83.38±9.45), (84.73±7.56), and (82.36±8.41) in the observation group, which were higher than those the control group (all P<0.05). Conclusion The application of mind map in the treatment of colon cancer patients taking colostomy can effectively improve their cancer-related fatigue, self-management efficacy, and quality of life, so it is worthy of clinical promotion. Key words: Colonic colostomy; Nursing; Mind map; Cancer-related fatigue; Self-management efficacy; Quality of life

Objective To evaluate surgical repair of vesicorectovaginal fistula using transvaginal pedicled omentum pull-through combined transanal colon pull-through. Methods A total of 11 patients with postoperative vesicorectovaginal fistulas complicating female reproductive system malignant tumors undergoing repairement from Aug 2013 to Aug 2018 were retrospectively analyzed. In order to isolate, protect the bladder and eliminate residual vaginal cavity using transvaginal pedicled omentum pull-through, combined transanal colon pull-through to repair vesicorectovaginal fistula. Results All the 11 patients in this group completed the operation successfully, and no air or stool passing from the vaginal after the operation. The fistula disappeared in five patients confirmed by cystography and enterograph. The average operation time was 115 min, the average blood loss was 260 ml.Incision fat liquefaction was found in two. Incision infection occurred in one. Urinary dysfunction in two. Anal stenosis was found in four patients which were healed by anal dilation. Conclusions Transvaginal pedicled omentum pull-through combined transanal colon pull-through can eliminate vesicorectovaginal fistula, improve life quality and avoid colostomy. Key words: Vesicovaginal fistula; Rectovaginal fistula; Omentum; Anal canal

PE76 - Robot assisted cystectomy in the presence of a colostomy

Objective To explore the application of fast track surgery (FTS) concept in perioperative period of parastomal hernia of colostomy. Methods 40 patients with colorectal cancer who underwent laparoscopic hernia repair of parastomal hernia of colostomy in Chengdu Shangjin Nanfu Hospital between February 2015 and September 2018 were selected and divided into the experiment group and the control group by random number table method, 20 cases in each group. The control group received routine nursing care during the perioperative period, the experiment group used perioperative nursing care under the guidance of the FTS concept. The clinical parameters, the depression/anxiety status before and after treatment and the ostomy-related self-efficacy at discharge of the 2 groups were compared, the postoperative complications were recorded. Results Compared with the control group, the eating time, spontaneous bedtime and hospital stay significantly advanced in the experiment group (P<0.05). Compared with period before treatment, the scores of SDS and SAS significantly decreased 1 month after discharge in the 2 groups, and the experiment group was significantly lower than the control group (P<0.05). Compared with the control group, the scores of the ostomy-related self-efficacy and 6 individual items when discharge in the experiment group significantly increased (P<0.05). The incidence of total complications in the experiment group was significantly lower than that in the control group (P<0.05). Conclusion Perioperative nursing care under the guidance of FTS concept can significantly alleviate the depression and anxiety status of patients with colorectal cancer who underwent parastomal hernia repair, improve postoperative ostomy-related self-efficacy, reduce the incidence of postoperative complications, promote early recovery of the patients. Key words: Fast track surgery concept; Parastomal hernia; Perioperative period; Effect

As an extremely rare malformation, congenital pouch colon is characterized by shortened colon, markedly dilated pouch and anorectal malformations. In boys, pouch usually terminates in a colovesical fistula; in girls, terminal fistula opens into urethra or vestibule. Clinical presentations are typical and and its diagnosis is easily made by a large gas shadow or air-fluid level on radiograph. Its clinical managements and surgical options have remained controversial. Staged repair is performed after colostomy or ileostomy. Yet tubularization of dilated segment is dependent on the length of normal colon. Key words: Colon, abnormalities; Congenital pouch colon

Objective To explore the intervention effects of the group self-affirmation training on the stigma in the rectal cancer patients with colostomy. Methods By convenience sampling, 89 rectal cancer patients with colostomy in Yancheng Third People's Hospital from April 2017 to April 2018 were selected and divided into the experimental group (n=45) and control group based on the random number table (n=44) .The experimental group received group self-affirmation training on the basis of the conventional nursing care while the control group received the conventional nursing care. The self-designed General Information Questionnaire, Social Impact Scale (SIS) , Self-Esteem Scale (SES) were used to evaluate the stigma and level of self-esteem before and after intervention. Results Before intervention, the two groups had no statistical difference in the scores of stigma (t=-0.323, P=0.747) and level of self-esteem (t=-0.270, P=0.788) ; after intervention the experimental group had lower scores than the control group in stigma (t=-3.008, P<0.01) and higher scores than the control group in self-esteem (t=4.033, P<0.01) with statistical significance. Conclusions Group self-affirmation training can reduce the stigma of rectal cancer patients with colostomy and improve their self-esteem. Key words: Rectal neoplasms; Colostomy; Stigma; Group self-affirmation training; Self-esteem; Social influence

Introduction: Strides continue to be made in the care of patients following Intestinal Transplantation (ITx) yet, rejection continues to be a threat to its’ success. A temporary ostomy to assess the mucosa and easily perform a biopsy remains the diagnostic gold standard. However, patients with an ostomy may have high output and decreased renal function. A change in intestinal flora, as stool and mucosa are exposed to air, may trigger rejection. Methods: We retrospectively reviewed 101 primary ITx performed from Jan 2013 to Dec 2018. 27 Isolated Intestine-Colon transplants and 7 Modified MVT were excluded. 67 patients underwent a MVT. 4 died in OR from bleeding and 1 within 72 hours thus excluded as abdominal closure was not performed. Standard immunosuppression was induction with antithymoglobulin/rituximab and maintenance with tacrolimus/mTOR inhibitor. Results: Of 62 patients, 50 had 1-year follow up. 26 were pediatric (1-15yr) and 24 adult (19–68 yr). In 54% (27/50), no ostomy was performed. In 46%, an ostomy was performed- ileostomy in 12% (6/23), colostomy in 32% (16/23), hybrid colon ostomy in 2% (1/23). There was no difference between groups (Ostomy/No Ostomy) in length of stay (LOS) or admissions within the first year. LOS was 79 days with Ostomy(13–232) and 80 days (14–360) in No Ostomy. There was a trend for earlier discontinuation of parenteral nutrition in No Ostomy(32 days) vs. Ostomy(53 days). Initial endoscopy occurred earlier in Ostomy at 10 vs. 27 days in No Ostomy[F (1,48) = 15.99, p=0.0002]. Number of scopes performed in the 1st year were significantly less in patients with No Ostomy(mean = 6) vs. Ostomy(mean = 11) [F (1,48) = 15.17, p=0.0003] (Fig 2). Despite this, there was no significant difference in rejection. There was a trend toward increased rejection in patients with Ostomy(35%, 8/23) vs. No Ostomy(19%, 5/27). There was no difference in creatinine pre-transplant (non-renal) nor at 1-year post. However, the majority of patients with an ostomy (colostomy + hybrid colon) had colon in continuity making dehydration less likely. Patient 1-year survival did not differ at 82% (4/23) for those with Ostomy and 78% (6/27) with No Ostomy. Conclusion: MVT without an ostomy continues to be feasible and safe without an increased risk of rejection nor death. Postop care seems to be easier and preservation of kidney function may impact long term ITx outcomes. Lack of ostomy greatly adds to patient satisfaction and quality of life.

Objective To investigate the current status and influencing factors of anxiety and depression in rectal cancer patients with permanent intestinal orifice. Methods By convenience sampling, we selected the rectal cancer patients with permanent intestinal orifice who were admitted to Department of Colorectal and Anal Surgery in the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2018 as our participants in the study. They were investigated by Anxiety Self-Rating Scale and Depression Self-Rating Scale. Totally 165 questionnaires were distributed with 157 valid ones retrieved. Results In the 157 patients, 74 patients (47.13%) suffered from anxiety: 32 of them had mild anxiety and 42 patients had moderate anxiety. In the 157 patients, 95 (60.51%) of them suffered from depression: 54 patients had mild depression, 36 patients had moderate depression and 5 patients had severe depression. Patients who were females, working staff, have low income, impaired ability of self-care, have not received the preoperative education, or have postoperative complications tend to develop anxiety and depression (P<0.05) . Conclusions There is a higher proportion of rectal cancer patients with permanent intestinal orifice who had anxiety and depression. The influencing factors are various and complex, and targeted intervention has positive significance in improving the patients' negative mood. Key words: Rectal neoplasms; Anxiety; Depression; Colostomy