[Show abstract][Hide abstract] ABSTRACT: The pancreas is an exocrine and endocrine digestive organ in the gastrointestinal tract. The exocrine function of the pancreas aids in digestion of carbohydrates, protein, and fat, whereas the endocrine or hormone-producing function assists in glucose homeostasis. Acini cells produce pancreatic enzymes and an aqueous solution. Three main pancreatic enzymes (amylase, trypsin, and pancreatic lipase) assist in carbohydrate, protein, and fat digestion. The aqueous solution functions to raise duodenal pH. This pH is neutralized by gastric acid, allowing increased pancreatic acid activity (Brendle, 2010).
Preview · Article · Aug 2015 · Clinical Journal of Oncology Nursing
[Show abstract][Hide abstract] ABSTRACT: Hepatic artery infusion pump (HAIP) use in chemotherapy started in the 1960s as a way to treat liver metastases that were not amendable to locoregional therapy or surgical resection. Because of complications and limited survival benefit, the use of HAIPs fell out of favor. A resurgence has occurred in the use of these pumps, but limited information is available in the literature guiding nursing care of these patients.
The purpose of this study was to review the literature regarding the use, procedures, and nursing care of patients with HAIPs.
A systematic literature review was conducted to obtain a comprehensive range of publications.
Database searching resulted in 511 titles and abstracts. After eliminating duplicates and nonrelevant titles, 65 remained and were read in full. Of these, 20 were excluded because they did not fit the inclusion criteria.
Preview · Article · Jun 2015 · Clinical Journal of Oncology Nursing
[Show abstract][Hide abstract] ABSTRACT: To compare outcomes and feasibility of double-barreled wet colostomy and ileal conduit (IC) in patients undergoing total pelvic exenteration (TPE).
Between 2004 and 2010, 54 patients underwent TPE for pelvic malignancies. Of those patients, 53 had complete records available for analysis. Two groups were identified based on the technique used for urinary diversion, either by way of an IC or a double-barreled wet colostomy (DBWC). Demographics, comorbidities, complications, length of stay, operative times, morbidity, and mortality were compared between the 2 groups.
Forty-three patients (81%) underwent a DBWC and ten patients (19%) underwent an IC. The 2 groups were similar in terms of age, gender, and comorbidities. Eighteen patients underwent an R0 resection (39%) and twenty-eight (61%) patients had a non-R0 resection. Seven patients (13%) had a complete response to therapy with no evidence of malignancy. A majority of the patients (68%) undergoing TPE had colorectal histology. Thirty-day morbidity directly related to complications of urinary or fecal diversion was 78% in the DBWC group and 58% in the IC group. There was no perioperative mortality in either group.
DBWC is a safe and feasible alternative to the traditional IC for urinary diversion. This technique is easy to learn and is associated with similar operative times, length of stay, morbidity, and mortality compared with IC.