Quality of life with a temporary stoma

Gooszen, A. W.; Geelkerken, R.H.; Hermans, J.; Lagaay, M B; Gooszen, Hein G.

doi:10.1007/bf02235581

Cited by 192 publications

(155 citation statements)

References 13 publications

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“…This policy might result in a longer hospital stay and higher overall costs. However, this needs to be balanced with a low rate of faecal diversion which is associated with decrease in quality of life and iterative hospitalisations [38][39][40][41] and the low rate of post-operative morbidity with no need for re-admissions. Consensus on incorporating this strategy and discussing the relative place of surgery and medical treatment is required.…”

Section: Discussionmentioning

confidence: 99%

Pre‐operative management is associated with low rate of post‐operative morbidity in penetrating Crohn’s disease

Zerbib

Koriche

Truant

et al. 2010

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Pre‐operative management is associated with low rate of post‐operative morbidity in penetrating Crohn’s disease

Zerbib

Koriche

Truant

et al. 2010

Aliment Pharmacol Ther

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“…Temporary loop ileostomy remains a major psychological handicap and causes significant physical stress, leading to an adverse effect on quality of life 9,10 . Furthermore, patients with rectal cancer are increasingly being offered postoperative adjuvant therapy, which creates uncertainty about the timing of stoma closure 11 .…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy

Alvès

Panís

Lelong

et al. 2008

British Journal of Surgery

152

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Background: Temporary faecal diversion is recommended with a low colorectal, coloanal or ileoanal anastomosis (LA). This randomized study evaluated early (EC; 8 days) versus late (LC; 2 months) closure of the temporary stoma.Methods: Patients undergoing rectal resection with LA were eligible to participate. If there was no radiological sign of anastomotic leakage after 7 days, patients were randomized to EC or LC. The primary endpoints were postoperative morbidity and mortality 90 days after the initial resection.Results: Some 186 patients were analysed. There were no deaths within 90 days and overall morbidity rates were similar in the EC and LC groups (31 versus 38 per cent respectively; P = 0·254). Overall surgical complication (both 15 per cent; P = 1·000) and reoperation (both 8 per cent; P = 1·000) rates were similar, but wound complications were more frequent after EC (19 versus 5 per cent; P = 0·007). Small bowel obstruction (3 versus 16 per cent; P = 0·002) and medical complications (5 versus 15 per cent; P = 0·021) were more common with LC. Median (range) hospital stay was reduced by EC (16 (6-59) versus 18 (9-262) days; P = 0·013). Conclusion:Early stoma closure is feasible in selected patients, with reduced hospital stay, bowel obstruction and medical complications, but a higher wound complication rate. Registration number: NCT00428636 (http://www.clinicaltrials.gov).

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“…Furthermore, quality-oflife issues need to be addressed 20 , as there seems to be a clear relationship between stoma care problems and the degree of social restriction. Thus, not only is a careful surgical technique required, but also the stoma type has to be carefully chosen in order to have a healthy stoma 21 . Clearly, it remains controversial as to whether loop ileostomy or loop colostomy is the most favourable proximal diversion for colorectal anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

et al. 2008

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Purpose:The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. Methods: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. Results: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I 2 = 0% for the heterogeneity test. Conclusions: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials. Key words: Ileostomy. Colostomy. Colorectal surgery. Systematic review. Meta-analysis. RESUMO Objetivo:A controvérsia entre ileostomia em alça ou colostomia em alça como a melhor forma para a descompressão temporária da anastomose colorretal motivou a realização desta revisão. Métodos: Cinco ensaios clínicos casualizados foram incluídos com 334 pacientes: 168 no grupo de ileostomia e 166 no grupo de colostomia. Os resultados analisaram: 1. Mortalidade; 2. Infecção da ferida; 3. Tempo de formação do estoma; 4. Tempo de fechamento do estoma; 5. Intervalo de tempo entre a formação e o fechamento do estoma; 6. Prolapso do estoma; 7. Retração do estoma; 8. Hérnia parastomal; 9. Fistula parastomal; 10. Estenose; 11. Necrose; 12. Irritação de pele; 13. Íleo; 14. Fístula entérica; 15. Reoperação; 16. Adaptação do paciente; 17. Tempo de internação hospitalar; 18. Deiscência da anastomose colorretal; 19. Hérnia de Incisional; 20. Obstrução intestinal pós-operatória. Resultados: Prolapso do estoma: p = 0.00001, mas com heterogeneidade estatística; a análise de sensibilidade foi aplicada excluindo os estudos que incluíram cirurgias de emergência: p = 0.02 e teste de heterogeneidade: I 2 =0%. Conclusões: Os resultados encontrados não foram estatística ou clinicamente significantes, exceto prolapso do estoma. A melhor evidência para a escolha entre ileostomia em alça ou colostomia em alça necessita de maior número de ensaios clínicos.

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Quality of life with a temporary stoma

Cited by 192 publications

References 13 publications

Pre‐operative management is associated with low rate of post‐operative morbidity in penetrating Crohn’s disease

Pre‐operative management is associated with low rate of post‐operative morbidity in penetrating Crohn’s disease

Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

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