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  • Title: Prospective analysis of stoma-related complications.
    Author: Robertson I, Leung E, Hughes D, Spiers M, Donnelly L, Mackenzie I, Macdonald A.
    Journal: Colorectal Dis; 2005 May; 7(3):279-85. PubMed ID: 15859968.
    Abstract:
    BACKGROUND: Stoma-related complication rates vary between 10% and 70%, possibly because of varying lengths of follow-up. It is thought that most of the complications improve with time. Furthermore, little is known about the commonly neglected but potentially quite distressing complications such as leakage, soiling and night-time emptying. The aim of this audit was to examine prospectively whether there was any difference in the complication rates at different time-points during the postoperative follow up period. METHOD: A prospective study on 408 consecutive patients with either colostomy or ileostomy was conducted over a period of at least 2 years. Both emergency and elective procedures were included. Stoma related complications were analysed at 10 days, 3 months, 6 months, 1 year and 2 years postoperatively. RESULTS: Both elective and emergency stomas had similar complication rates. The percentage of patients who had stenosis (1-2%), retraction (8-22%), prolapse (1-3%) or odour (6-9%) did not significantly change with time. The complication rates for skin excoriation, leakage, soiling or night-time emptying were higher amongst the ileostomy patients, and these rates did not improve with time. The proportion of patients who had parastomal hernias increased with time (from 0 to 40% in the colostomy and 0 to 22% in the ileostomy group). Daytime leakage, night-time leakage, soiling and night-time emptying were more problematic in the ileostomy group. CONCLUSIONS: The proportion of patients who had postoperative stoma-related complications did not improve with time, but the rate of parastomal hernias in both groups and night-time emptying in the ileostomy group was worse with time. Ileostomy patients had a higher incidence of skin excoriation, leakage, soiling, and night-time emptying, and they should receive additional support.
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