Profile of intestinal stomas at a tertiary referral centre of central India

Abstract

The aim of study was to evaluate various types of stoma with regard to their indications, their complications and methods to reduce them, at a tertiary hospital of central India. Methods: The study was carried out in Department of surgery at M. L. N. Medical College, Allahabad from August 2013 to July 2014. Adult patients who were admitted here and had Ileostomy/colostomy formation/closure as a part of their treatment were included. Data was collected by meticulous history taking, clinical examination and investigations. Results: A total of 100 patients were included (Avg. 34 year) and male: female ratio was 1.6:1. The most common stoma constructed was ileostomy (82%) with loop ileostomy (62%) being the most common subtype. Among colostomies, loop was most common (50%). Main indication of stoma formation was intestinal perforation (63%). In individual causes, Typhoid Perforation (44%) was most common indication. 85% patients had stoma complications, most common being peristomal skin excoriation (80%). Study of closure of stoma was done in a total of 50 patients. Closure of 43 ileostomies and 7 colostomies was done. Mean length of postoperative stay was 11 days. 28% developed complication among which paralytic ileus, (16%) was most common. Conclusion: Despite extensive surgical experience, complications of intestinal stomas still occur frequently and result in high morbidity. Meticulous skin care with regular follow-up, early detection of complications with their timely management along with education and counseling can decrease morbidity.