Life Table analysis of stomal complications following colostomy

Londono-Schimmer, E. E.; Leong, A. P. K.; Phillips, R. K. S.

doi:10.1007/bf02052598

Cited by 401 publications

(314 citation statements)

References 11 publications

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“…5 Persistently 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.…”

mentioning

confidence: 99%

Complications and mortality following stoma formation

Harris

Egbeare²,

Jones³

et al. 2005

Ann R Coll Surg Engl

149

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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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confidence: 99%

Complications and mortality following stoma formation

Harris

Egbeare²,

Jones³

et al. 2005

Ann R Coll Surg Engl

149

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“…Londo-Schimmer et al [5] reported that the complication of paracolostomy hernia occurred in 43 out of 203 patients (21.1 %) after colostoma installation. In our institution, however, the paracolostomy hernia complication occurred in 6 out of 427 patients (1.4%) who had colostoma (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Because of little postoperative invasion and prevention of recurrent adhesive ileus, laparoscopic operation is increasingly conducted to treat adhasive ileus [1][2][3]. Paracolostomy hernia and ileus have been reported in 21% and 5.4%, respectively of all late postoperative complications of colostomy [4,5]. The patient of this report suffered from a complication of paracolostomy hernia after abdominoperineal proctectomy and, as the result, adhesive ileus.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Ileus Operation due to Paracolostomy Hernia.

et al. 2001

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“…The correlation between the position of the stoma within the abdominal wall was studied by Sjodahl et al who demonstrated an advantage for enterostomy constructed through the rectus abdominis muscle [18], though in similar studies this association was not statistically significant [14,19,20]. One study has shown better results for extra-peritoneal positioning of the stoma, but there are no prospective randomized clinical trials comparing these two methods [13,19]. Other technical issues showing equivalent results are anchoring of the distal bowel segment to the abdominal wall [19,20], the site of hernia in relation to the main incision [21] and laparoscopic versus open approach [9].…”

Section: Risk Factor For the Development Of Phmentioning

confidence: 99%

“…When using an accurate measurement to create the trephine, the rate of PH dropped [17]. The correlation between the position of the stoma within the abdominal wall was studied by Sjodahl et al who demonstrated an advantage for enterostomy constructed through the rectus abdominis muscle [18], though in similar studies this association was not statistically significant [14,19,20]. One study has shown better results for extra-peritoneal positioning of the stoma, but there are no prospective randomized clinical trials comparing these two methods [13,19].…”

Section: Risk Factor For the Development Of Phmentioning

confidence: 99%

Parastomal Hernia Is a Problem Yet to Be Solved

2015

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Parastomal hernia is a common surgical problem which is associated with discomfort and irritation in addition to acute complications. This review presents the history, different classifications and terms which are used to describe parastomal herniation. It also details the different techniques for parastomal hernia diagnosis and presents evidencebased risk factors associated with its occurrence. It gives a detailed overview of modern treatment options and discusses different strategies for repair of parastomal hernia as well as advantages and disadvantages for each technique.

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Life Table analysis of stomal complications following colostomy

Abstract: The evidence in this study that spans a 22-year period questions much surgical technical dogma and raises the possibility that parastomal hernias may, like inguinal hernias, represent a failure in the transversalis fascia that might technically be avoidable.

Cited by 401 publications

References 11 publications

Complications and mortality following stoma formation

Complications and mortality following stoma formation

Laparoscopic Ileus Operation due to Paracolostomy Hernia.

Parastomal Hernia Is a Problem Yet to Be Solved

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