Nursing Care Plan for Colon Cancer with Enterocutaneous Fistula and Sepsis Complication: Case Study

Abstract

Background: Colon cancer is a major public health problem with an increasing trend in the population worldwide. The main treatment for this disease is surgery, but postoperative complications such as enterocutaneous fistula and sepsis are problems that affect the length of hospital stay and quality of life of patients. Appropriate nursing care plays an important role in reducing complications and increasing the efficiency of patients' recovery.

Objectives: (1) To study nursing care for colon cancer patients who develop complications of enterocutaneous fistula and sepsis. (2) To provide nurses with guidelines for planning effective care for patients undergoing colon cancer surgery. (3) To provide guidelines for practice in reducing complications and increasing the quality of life of patients.

Research methodology: This study was a descriptive case study using the nursing process as a guideline for patient care. Two patients who underwent colon cancer surgery and developed complications were selected. Data were collected from medical records, interviews, and nursing observations. Data were analyzed using content analysis to identify nursing problems, nursing diagnoses, and appropriate solutions.

Results: Patient 1 was a 48-year-old male patient who underwent colostomy closure and developed a postoperative fistula and intraabdominal infection. This resulted in long-term monitoring for complications, with a total hospital stay of 117 days. The second patient was a 60-year-old male patient who underwent sigmoidectomy with end colostomy and developed septic shock. He required monitoring and treatment for septic shock, with a total hospital stay of 13 days. Important nursing interventions included perforation wound care using Negative Pressure Wound Therapy (NPWT), antibiotic administration, nutritional monitoring, and dehydration, and providing psychological support to patients and their families.

Conclusion: The results of the study indicated that systematic and evidence-based nursing care can effectively reduce complications after colon cancer surgery, especially perforation wound management and prevention of septic shock. In addition, coordination with the multidisciplinary team and providing education to patients’ relatives play an important role in helping patients to continue taking care of themselves after discharge.