DOI: http://dx.doi.org/10.18203/2349-2902.isj20190816

A clinico-observational study of intestinal stoma and their complications

Shyam Bhutra, Amit Singh, Ramkishore Darwal, Piyush Jain, Vineet Kala

Abstract


Background: The present study is designed to study the indications of intestinal stoma formation, type of stoma formation, complications of intestinal stoma made in patients under emergency or elective setting and postoperative care of the intestinal stomas.

Methods: The study was carried out in Department of surgery at J. L. N. Medical College, Ajmer from January 2016 to September 2017. In this study only >12 years age patient were included. The data were collected prospectively and analysed.

Results: It was observed that most patients were operated in emergency (90%) as compare to elective (10%) setting for the formation of intestinal stomas. The stoma was formed more in male (58%) as compared to female (42%). There were two peak age group 31-45 year and 45-60 years in which more stoma formation occur. The common indications for stoma were found to be ileal perforation with gangrenous ileum. The common stoma formed was ileostomy (64%) in compared to colostomy (34%). The loop stomas were formed in compared to end stoma and temporary stoma (84%) more formed compared to permanent stoma (16%). The most common complications were found to be skin excoriation (64%) as compared to other complications.

Conclusions: Despite increasing surgical expertise, complications of intestinal stomas still occur frequently in all setups and result in high morbidity. Meticulous skin care with regular follow-up, early detection of complications with their timely management along with education and counselling can decrease morbidity.

Keywords


Complications, Colostomy, Ileostomy, Intestinal stoma, Stoma care

Full Text:

PDF

References


Taylor P. An introduction to stomas: reasons for their formation, Nurs Times. 2005;101(29):63-4.

Aziz A, Sheikh I, Jawaid M, Alam SA, Saleem M. Indications and complications of loop ileostomy. J Surg Pak. 2009;14 (3):128-31.

Brand MI, Dujovny MDN. Preoperative Considerations and Creation of Normal Ostomies. Clin Colon Rectal Surg. 2008;21(1):5–16.

Jayarajah U, Samarasekara AMP, Dharmabandhu N, Samarasekera A. study of long term complications associated with enteral ostomy and their contributory factors. BMC Res Notes. 2016;9:500.

Harris DA, Egbeare D, Jones S, Benjamin H, Woodward A, Foster ME. Complications and mortality following stoma formation. AnnR Coll Surg Engl. 2005;87(6):427–31.

Duchnesne JC. Wang Y. Stoma complication: a multivariate analysis. A M Surg. 2002:68:961-6.

Arumugam PJ, Bevan L, Macdonald L, Watkins AJ, Morgan AR, Beynon J, et al. A prospective audit of stomas analysis of risk factors and complications and their management. Colorectal Dis. 2003;5:49.

Mahjoubi B, Moghimi A, Mirzael R, Bijari A. Evaluation of the end colostomy complications and the risk factors influencing them in Iranian patients. Colorectal Dis. 2005;7:582-7.

Robertson I, Leung E, Hughes D, Spiers M, Donnelly L, Mackenzie I, et al. Prospective analysis of stoma related complications. Colorectal Dis. 2005;7:279-85.

Krouse RS, Grant M, Rawl SM, Mohler MJ, Baldwin CM, Coons SJ, et al. Coping and acceptance .the greatest challenge for veterans with intestinal stoma. J Psychosom Res. 2009;66(3):227-33.

Caricato M, Ausania Ripetti V, Bartolozzi F, Campoli G, Coppola R. Retrospective analysis of long term defunctioning stoma complications after colorectal surgery. Colorectal Dis. 2006;9:559-61.

Salvadalena G. Incidence of complication of the stoma and peristomal skin among individuals with colostomy, ileostomy and urostomy: a systemic review. J Wound Ostomy Cont Nurs. 2008;35(6)596-607.

Nybeek H, Knudsen DB, Laursen TN, Karlsmark T, Jemec GBE. Skin problem in ostomy patients. A case control study of risk factor. Acta- Dermato-Venereologica. 2009;89(1):64-7.

Hellman J, Logo CP. Dermatological complication in colostomy and ileostomy patients. Int J Dermatol. 1990;29(2):129-33.

Hanna MH, Vinci A, Pigazzi A. Diverting ileostomy in colorectal surgery when it is necessary? Langenback’s archieves of surgery/Deutsche Gesells- chaft Fur Chirugie. 2015;400(2):145-52.