The morbidity and mortality of colostomy closure

Samhouri, Farouq; Grodsinsky, Carlos M.

doi:10.1007/bf02609313

Cited by 24 publications

(6 citation statements)

References 12 publications

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“…This is consistent with most current trials, 10,13 and adds weight to the recommendation that loop ileostomies are to be favoured over loop colostomies in defunctioning low colorectal anastomoses. Although others 14 have found no difference in complication rate between the two defunctioning stomas, the quality of life in patients with an ileostomy is enhanced over those with a colostomy.…”

Section: Discussionsupporting

confidence: 86%

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Complications and mortality following stoma formation

Harris

Egbeare²,

Jones³

et al. 2005

Ann R Coll Surg Engl

150

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Ann R Coll Surg Engl 2005; 87: 427-431 427The annual incidence of stoma formation in England is 20,800, 1 although recent literature would suggest that this figure is unnecessarily high. The management of obstructing left-sided colorectal cancer has changed in recent times, with increased use of on -table lavage with primary resection and anastomosis 2,3 and colorectal stenting 4 to avoid stoma formation. Sphincter preserving surgery for rectal cancer should also reduce permanent stoma rates. 5Persistently high morbidity and mortality rates associated with stoma creation and reversal are behind attempts to reduce their formation. Long-term complication rates of 58% in colostomies 6 and up to 76% in ileostomies 7 have been reported. It is also recognised that around 15% of temporary stomas created at the time of anterior resection become permanent. 8There has been much recent work examining risk factors for mortality in colorectal cancer surgery, 9 such as ASA grade and age, but whether the presence of a stoma affects mortality has not been previously examined. Studies have addressed the mortality following stoma reversal (0-4%), 10 but the literature is scant when stoma creation is concerned.We have examined whether the incidence of stoma formation is declining in the practice of a typical district general hospital, and investigated the prevalent morbidity and mortality associated with stoma creation, together with their risk factors. Patients and MethodsAll patients undergoing colostomy or ileostomy formation (elective and emergency) from January 1992 to December 2000 were identified. Data were collected from patient records maintained prospectively by the stomatherapy department, supported by information from operation notes and patient case records. Complications recorded were necrosis, prolapse, peristomal infection or abscess, retraction, stenosis, parastomal hernia, fistula and malignant change at the stoma site.Complications not included were skin excoriation and laparotomy wound problems.Operations were performed by one of seven consultant general surgeons or their registrars, three of whom had a declared interest in coloproctology. Patients undergoing bowel resection without stoma formation were not studied. Statistical analysisResults are expressed as the mean (SD) Stoma Care, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, Mid-Glamorgan, UK ABSTRACT INTRODUCTION As stoma formation is thought to be declining, we performed a study to evaluate the rate of stoma formation and the impact on stoma complication rates, together with risk factors for complications.

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Section: Discussionsupporting

confidence: 86%

“…8 There has been much recent work examining risk factors for mortality in colorectal cancer surgery, 9 such as ASA grade and age, but whether the presence of a stoma affects mortality has not been previously examined. Studies have addressed the mortality following stoma reversal (0-4%), 10 but the literature is scant when stoma creation is concerned.…”

mentioning

confidence: 99%

Complications and mortality following stoma formation

Harris

Egbeare²,

Jones³

et al. 2005

Ann R Coll Surg Engl

150

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“…Wound sepsis following skin closure during closure of a stoma would appear almost inevitable because the wound is contaminated [9]. It is a surgical principle that contaminated wounds be left open to heal by second intention.…”

Section: Discussionmentioning

confidence: 99%

Wound infection after ileostomy closure: a prospective randomized study comparing primary vs. delayed primary closure techniques

et al. 2005

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“…Nonetheless, it may be associated with an appreciable morbidity, the commonest of which is wound sepsis. The incidence of wound sepsis ranges from 2 to 37% 1,2 but most series report an incidenceof approximately 10% 3−5 . Wound herniation is the second most common complication and may, to a certain extent, be exacerbated by the presence of wound sepsis, leading to delayed or impaired wound healing.…”

Section: Introductionmentioning

confidence: 99%