Complications and Quality of Life After Stoma Surgery: A Review of 16,470 Patients in the UOA Data Registry

Fleshman, James W.; Lewis, Michael G.

doi:10.1053/j.scrs.2006.12.006

Cited by 18 publications

(20 citation statements)

References 14 publications

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“…7 To our knowledge, no previous study has looked at the response of people to having a stoma formed to manage bowel function (as opposed to removing diseased bowel), with the exception of people after spinal cord injury. Studies of spinal cord injury patients who had a stoma formed because of bowel management problems have found reduced time taken for bowel care, improved quality of life, and with no patients wanting the stoma closed.…”

Section: Discussionmentioning

confidence: 99%

“…7,15,[17][18][19][20] Forty-two percent of the current sample had experienced a hernia, but some were as yet not up to ten years after surgery, so it is not possible to compare results. A higher rate than for other stoma patients might be because of a common etiology with the original incontinence (for example muscle weakness or poor collagen).…”

Section: Discussionmentioning

confidence: 99%

“…Fifty-two of 69 patients (75 percent) reported previous surgery for incontinence (with a median 2 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] operations in these 52 people). Of these, 34 reported previous anal sphincter repair, 17 previous postanal repair, 15 surgery for rectal prolapse, and 6 other operations.…”

Section: Previous Incontinence Historymentioning

confidence: 99%

See 2 more Smart Citations

Patients' Views of a Colostomy for Fecal Incontinence

Norton

Burch

Kamm

2005

Diseases of the Colon &Amp; Rectum

117

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Previous Incontinence Historymentioning

confidence: 99%

See 1 more Smart Citation

Patients' Views of a Colostomy for Fecal Incontinence

Norton

Burch

Kamm

2005

Diseases of the Colon &Amp; Rectum

117

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“…Stoma prolapse is full-thickness protrusion of bowel through a stoma that occurs in 3% of ileostomies, 2% of colostomies, and 1% of urostomies. 47 Stoma prolapse can be classified as sliding (if occurs intermittently with increased intra-abdominal pressure) or fixed (if it is present constantly). Prolapse occurs more frequently with loop colostomies than end colostomies and most frequently involves the efferent (distal) limb.…”

Section: Stoma Prolapsementioning

confidence: 99%

Stoma Complications

Krishnamurty

Blatnik

Mutch

2017

Clinics in Colon and Rectal Surgery

153

157

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).Roughly 150,000 stomas are created in the United States annually, equally divided between ileostomies and colostomies.1 When created properly, an ileostomy or colostomy can dramatically improve a patient's quality of life. Patients with a good functioning stoma can expect to live a normal life with very few lifestyle restrictions. In contrast, when a patient develops complications related to their stoma, the impact on their physical and mental health can be irreparable. Stomas can be created for a multitude of diseases such as colorectal cancer, ulcerative colitis, Crohn's disease, diverticulitis, ischemic colitis, radiation injury, and fecal incontinence. The associated morbidity and overall function of a stoma are dependent upon the indication for the stoma, whether it was created electively or emergently, and patient factors such as body habitus and prior surgery. Unfortunately, significant morbidity is associated with stoma creation and these complications can be grouped into early and late-occurring complications. The literature reports the rate of stoma-related complications ranging from 20 to 70%.2-7 Early complications occur within the first 30 days of the stoma creation and include ischemia/necrosis, retraction, mucocutaneous separation, and parastomal abscess. Late complications include parastomal hernia, prolapse, retraction, and varices. All of these complications will be discussed to better understand etiologies and management options. Risk Factors for Stoma-Related ComplicationsAs mentioned previously, stoma creation carries significant morbidity, and disease, patient, clinical, and stoma-specific factors influence the outcomes pertaining to their creation. Harris et al found the most common stoma-related complications in 345 ostomates were herniation, retraction, necrosis, infection, prolapse, stenosis, fistula, and small bowel obstruction (SBO). 4 Complications were more common with colostomies except for SBO, which were more prevalent with ileostomies. The authors also found that loop colostomies had the highest complication rate out of all stoma configurations. Postoperative stoma necrosis was strongly and significantly associated with emergency stoma creation. Parmar et al identified that colostomies, short stoma length, body mass index > 30, emergency surgery, and lack of preoperative marking were associated with increased risks of complications. 7 None of the identified studies was adequately powered to stratify postoperative stoma-related complication rates by specific disease processes. Parastomal HerniaParastomal hernias are incisional hernias at ostomy sites and are believed to be an inevitable consequence of having an Keywords ► parastomal hernia ► stoma prolapse ► colostomy ► ileostomy ► parastomal varices AbstractWhen created properly, an ileostomy or colostomy can dramatically improve a patient's quality of life. Conversely, when a patient develops complications related to their stoma, the impact on physical and mental health can be profound. Unfortunately, significant morbidity is...

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“…1 Reported rates of stoma prolapse vary from 2% to 47%. 1,2,5,[7][8][9] In a review of the Cook County Hospital registry, including 1616 stomas, Park et al 1 found the overall incidence of stomal prolapse to be 2%. Londono-Schimmer et al 7 reported a cumulative risk of 11.8% at 13 years.…”

Section: Incidencementioning

confidence: 99%

Stoma Prolapse

Essani

2012

Seminars in Colon and Rectal Surgery

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Stoma prolapse after formation of an ileostomy or colostomy is a late complication. Prolapse is less common than parastomal hernia. This article reviews the incidence of prolapse, technical factors related to the construction of the stoma that may influence the incidence, and different options for repair. Stoma prolapse affects 2%-47% of individuals with ostomies. Transverse loop colostomy has the highest rate of stoma prolapse, especially because of the large redundant distal loop. Loop ileostomies were thought to have a higher prevalence rate in the past, but recent literature shows only a 2% prolapse rate for ileostomy as opposed to 47% for loop colostomy. The role of extraperitoneal stoma construction is uncertain. Fascial fixation and size of the fascial defect have not been proven to affect the incidence of prolapse. Local care of stoma prolapse is possible, especially if stoma is not incarcerated; however, reversal of stoma is preferable if possible. The options of surgical repair include reversal, resection, revision, and relocation. Semin Colon Rectal Surg 23:13-16 © 2012 Elsevier Inc. All rights reserved. D espite substantial advances in surgical technique and enterostomal therapy, complications after stoma creation remain extremely common. The rate of stoma-specific complications in the literature varies widely, ranging from 10% to 70%. 1-5 Stoma complications can be divided into early and late complications. Of the late complications, parastomal hernias are more common than stoma prolapse. Predisposing factors for development of stomal prolapse can be identified as patient factors, technique, and location of ostomy. This review describes the incidence of prolapse and assesses the technical factors related to the construction of the stoma that may influence this incidence. The different methods of repair have also been outlined.

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Complications and Quality of Life After Stoma Surgery: A Review of 16,470 Patients in the UOA Data Registry

Cited by 18 publications

References 14 publications

Patients' Views of a Colostomy for Fecal Incontinence

Patients' Views of a Colostomy for Fecal Incontinence

Stoma Complications

Stoma Prolapse

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