DOI: http://dx.doi.org/10.18203/2349-2902.isj20193325

Analysis of complications and management of abdominal stoma

Naresh Pal, Poonam ., Amit Jangra, Vineet Mishra

Abstract


Background: Abdominal stoma is an opening of the intestine whether temporary or permanent on anterior abdominal surgically. These are used to divert the faecal contents for safe distal anastomosis and to relieve obstruction in emergency surgeries or even in elective surgeries also. Though it is a lifesaving procedure and may be temporary or permanent. Sometimes it may result in number of significant complications which may be starting from early postoperative periods to late compilations.

Methods: This is a prospective observational study, which was carried on 85 patients of abdominal stomas in the department of general surgery, Pt. B D Sharma PGIMS Rohtak.

Results: In the present study there were (71) males and (14) females in the ratio of nearly 5:1. The males are 83.52% as compared females 16.47%.The commonest age group for stoma formation was in 21–30 years in either sex which is 23.52%. Numbers of males are higher in the age group of 51-60 years. The end ileostomy was made in 46 patients and loop ileostomy was in 27 patients. Oedema was seen maximally 19 patients of loop ileostomy. The other complications which are less common are retraction and ischemia of stomas. Four patients were died during treatment in this period in the present study.

Conclusions: Intestinal stomas are commonly performed surgical procedure for intestinal diseases, to minimise or decrease the potential complications due to intestinal stoma meticulous attention and extreme care should be employed in preoperative and postoperative periods. Here we have provided an overview of the complications seen in formation of intestinal stomas, keeping these probable complications in mind, decision making and surgical technique continue to be remain the keys to successful stoma formation. 


Keywords


Abdominal stoma, Ileostomy, Colostomy, Complications, Excoriations

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References


Kann BR, Cataldo TC. Early stomal complication. Clin Colon Rectal Surg. 2002;15:191–8.

Memon AS, Memon JM, Malik A, Soomro AG. Pattern of acute intestinal obstruction. Pakistan J Surg. 1995;11:91-3.

Crohn’s and Colitis Foundation of America. 386 Park Ave. S. 17th Floor. New York. NY. Available at: https://www.nchpad.org/Directories/ Organizations/2742/Crohn~s~~~Colitis~Foundation~of~America~~CCFA~. Accessed on 3 January 2019.

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

Duchesne JC, Wang Y, Weintraub SL, Boyle M, Hunt JP. Stoma complications: a multivariate analysis. Am Surg. 2002;68:961–6.

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.

MeGrath A, Porrett T, Heyman B. Parastomal hernia: an exploration of the risk factors and the implication. Br J Nurs. 2006;12;317-21.

Gooszen AW, Geelkerken RH, Herman J, Lagaay MB, Gooszen HG. Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Br J Surg. 1998;85:76–9.

Carlsen E, Bergen AB. Loop ileostomy: technical aspects and complications. Eur J Surg. 1999;165:140–3.

Porter JA, Salvati EP, Rubin RJ, Eisenstat TE. Complications of colostomies. Dis Colon Rectum. 1989;32:299–303.

Park JJ, Del Pino A, Orsay CP, Nelson RL, Pearl RK, Cintron JR, et al. Stoma complications: the Cook County Hospital experience. Dis Colon Rectum. 1999;42:1575–80.

Pearl RK, Prasad LM, Orsay CP, Abcarian H, Tan AB, Melzl MT, et al. Early local complications from intestinal stomas. Arch Surg. 1985;120:1145–7.

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;5:49-52.

Shah JN, Subedi N, Maharjan S. Stoma Reversal, a hospital based study of 32 cases. Int J Surg. 2009;22(1):1-5.

Ghazi MA, Bhutia AR, Muhammad H, Maqbool A, Dawood N, Mahmood N. The trends and outcome of stoma procedures in abdominal surgery, Pak J Med Health Sci. 2009;3(2):106.

Safirullah, Mumtaz N, Jan MA, Ahmed S. Complications of intestinal stomas. J Postgrad Med Inst. 2005;19(4):407-11.

Harris RP, Daly KJ, Jones LS, Kiff ES. Colorectal Dis. 2004;6(4):280-4.

Ratliff CR. Early Peristomal Skin Complications Reported by WOC Nurses. J Wound Ostomy Continence Nurs. 2010;37(5):505-10.

Jhobta RS, Attri AK, Kaushik R, Sharma R, Jhobta A. Spectrum of perforation peritonitis in India – Review of 504 consecutive cases. World J Emerg Surg 2006;1:26.

Grobler SP, Hoise KB, Keighley MRB. Randomized trial of loop ileostomy in restorative proctocolectomy. Br J Surg. 1992;79:903–6.