Impact of COVID-19 Outbreak on Stoma Surgery and Stoma Clinic Service: A Retrospective Study at a Single Japanese Referral Hospital

Abstract

Aim. The impact of the COVID-19 pandemic on medical practice has been frequently reported from Western countries, but there have been few studies in other areas, especially regarding stoma surgery and stoma care. Methods. We investigated the numbers of all operations and stoma-related surgeries at our hospital in 2019 and 2020. The cumulative numbers of consultations at our ostomy clinic and patient population stratified by the period of having a stoma were compared between these calendar years. The frequency of ostomy clinic visit by individual patients within the first year after stoma creation and stoma-related complications per consultation were also analyzed. Results. The number of elective surgeries decreased by approximately 10% from 2019 to 2020, but the numbers of stoma creation and closure procedures did not differ. The total numbers of consultations at our ostomy clinic were also similar between these years. However, the percentage of patients with a stoma for less than a year who visited our ostomy clinic increased from 49.7% in 2019 to 53.5% in 2020, whereas the visitation rate for other patients decreased. Moreover, patients with a stoma for less than a year visited the ostomy clinic more frequently in 2020 (0.42/month) than in 2019 (0.30/month, p = 0.032 ). There were fewer grade 2 or more severe peristomal complications in 2020 (11% vs 17% in 2019, p < 0.001 ) at our ostomy clinic. Conclusion. The COVID-19 outbreak led to a shift in the patient population at ostomy clinics of new stoma patients, which may have resulted in fewer peristomal complications.

Preoperative stoma site marking reduces postoperative stoma-related complications in emergency surgery: A single center retrospective cohort study

“…Parastomal hernia was also diagnosed by CT and/ or physical examination. As reported previously, 17 whether transient or persistent, stoma-related complications were graded by the Common Terminology Criteria for Adverse Events classification (CTCAE) version 5 (stoma site infection, stoma necrosis, stoma obstruction, stoma site bleeding, stoma prolapse, and stoma stenosis) 18 or defined by Takahashi et al 19 based on the CTCAE (mucocutaneous separation, parastomal hernia, stomal recession, peristomal fistula, and peristomal dermatitis).…”

Large Bowel Obstruction: Etiologies, Diagnosis, and Management

“…In addition, preoperative stoma marking, noting creases on the abdomen when the patient is sitting up, can decrease stoma complications and improve self-care postoperatively. 29 30 In the setting of LBO, preoperative mechanical bowel preparation is not possible and may precipitate perforation. Instead, on-table colonic lavage, performed by instilling 4 L of saline through the appendiceal orifice and collecting the effluent in anesthesia gas tubing secured to the cut end of the bowel, can reduce the colonic stool burden.…”