The effect of preoperative stoma site marking on risk of stoma-related complications in patients with intestinal ostomy—protocol of a systematic review and meta-analysis

Kugler, Charlotte Mareike; Breuing, Jessica; Rombey, Tanja; Heß, Simone; Ambe, Peter C.; Grohmann, Erich; Pieper, Dawid

doi:10.1186/s13643-021-01684-8

Cited by 13 publications

(19 citation statements)

References 36 publications

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“…The management of stoma is a multidisciplinary approach that includes surgeons, primary care physicians, stoma nurses, and stoma therapists. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

A study on patterns, indications, and complications of an enteric stoma

Pandiaraja

Chakkarapani²,

Shalini

2021

Journal of Family Medicine and Primary Care

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Introduction: Stoma could be a surgically created opening within the abdominal wall. The main purpose of the stoma is to divert the excreta off from the distal intestinal loops to relieve an obstruction or protect anastomosis. The indications for stoma creation are intestinal obstruction due to benign or malignant tumors, perforation peritonitis, inflammatory bowel disease, colorectal malignancies, and anorectal malformations. Aim of the study: The study aimed to identify the patterns, indications, and complications that occur following the creation of enteric stomas. Materials and Methods: It is a prospective observational study conducted from May 2012 to October 2015 on a hundred patients, who were admitted in the department of general surgery, surgical gastroenterology, and pediatric surgery, Government Stanley Medical College and Hospital. The sampling method followed here is the non-probability convenience sampling technique. The data is collected from all the patients who come under the inclusion criteria. Results: Of 100 patients, the majority of the patients belonged to 26–35 years and 46–55 years ( n = 25). Based on the study, loop colostomy is more common with age less than one year and loop ileostomy is more common in 26–55 years. The foremost common indication of an enteric stoma is a gastrointestinal malignancy (25%) followed by abdominal trauma (22%). In our study, an ileostomy (80%) is the most common type of stoma created followed by colostomy. Within the ileostomy, loop ileostomy is the more common (60%) followed by end ileostomy (20%). Among the complications related to an enteric stoma, skin excoriation (54.4%) is most common followed by surgical site infections (8.5%). Conclusion: Our study shows stoma creation is higher in the adult and old age group, mostly done as an emergency procedure compared to an elective procedure. So, better preoperative planning in both emergency and elective settings can reduce the number of stoma and its related complications. The duration of hospital stay is higher in stoma patients. So, the reduction in stoma creation leads to a reduction in complication, duration of hospital stays and indirectly reduces expenditure related to it. In our study, most of the stoma is created for obstruction in malignancy and perforation in trauma patients. From our study, we can observe early diagnosis of intestinal malignancy with a well-planned elective procedure or bride procedure like colonic stenting in malignant obstruction can reduce the number of stoma creation. Skin excoriation is the most complication followed by surgical site infections. These complications can be reduced by better postoperative stoma care and early reversal of stoma.

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“…The management of stoma is a multidisciplinary approach that includes surgeons, primary care physicians, stoma nurses, and stoma therapists. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

A study on patterns, indications, and complications of an enteric stoma

Pandiaraja

Chakkarapani²,

Shalini

2021

Journal of Family Medicine and Primary Care

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“…Ulteriori studi (8,14,15,16,17), inoltre hanno dimostrato come la mancanza del disegno preoperatorio risulti uno dei fattori di rischio, insieme al carattere d'urgenza dell'intervento, all'altezza dello stoma sul piano cutaneo, al tipo di stoma e all'indice di massa corporea, per l'incidenza di complicanze stomali.…”

Section: Premessaunclassified

“…Diventa quindi essenziale eseguire il disegno preoperatorio stomale (stoma siting). Con tale termine s'intende l'individuazione, da parte di personale infermieristico preparato e competente, del punto di ideale per il confezionamento dello stoma (10,11,14,15).…”

Section: Premessaunclassified

“…Tale procedura va eseguita in fase preoperatoria, in tutti i pazienti sottoposti al confezionamento di una stomia enterale o urinario in regime d'elezione e, dove la situazione lo possa consentire, anche in regime di urgenza/ emergenza (10,11,14,15).…”

Section: Premessaunclassified

“…La raccolta dati è stata effettuata tramite la consultazione di cartelle cliniche e la compilazione di un'apposita scheda (Appendice 1), costruita sulla base delle indicazioni di letteratura (5,(12)(13)(14)(15)17), che comprendeva le seguenti informazioni sulla popolazione di studio: dati amministrativi, quali unità operativa, data di ammissione e di dimissione del paziente; dati clinico-anamnestici del paziente come peso, altezza, diabete, BMI, esiti cicatriziali; dati relativi all' intervento chirurgico, quali la data e la tipologia d'intervento, la motivazione dell'intervento chirurgico (neoplastica, infiammatoria, traumatica), la data di esecuzione dello stoma siting preoperatorio e il relativo disegno dello stoma; dati relativi alla stomia, come la tipologia di stoma confezionata (colostomia, ileostomia, ureteroileostomia, ureterocutaneostomia), il tempo di permanenza della stomia (definitiva o temporanea), le complicanze stomali precoci e tardive. I dati sono stati esportati su un foglio di lavoro Microsoft Excel e successivamente sottoposti ad analisi per la valutazione delle complicanze stomali.…”

Section: Figura 1: Riassunto Diagrammatico Dello Studiounclassified

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Le complicanze stomali prima e dopo l’introduzione dello stoma siting effettuato dall’infermiere: uno studio retrospettivo

Foresti

2022

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PREMESSA: Il 3%-82% dei pazienti stomizzati va incontro a complicanze stomali, che determinano un aggravio assistenziale con allungamento della degenza e dei tempi di recupero dell’autonomia gestionale dello stoma. In letteratura emerge come la mancanza del disegno stomale preoperatorio risulti uno dei fattori che aumenta l’incidenza di complicanze stomali, insieme al carattere d’urgenza dell’intervento, all’altezza, al tipo di stoma e all’indice di massa corporea. SCOPO: Valutare il numero e le caratteristiche delle complicanze stomali, nel periodo precedente all’introduzione della procedura del disegno stomale preoperatorio eseguito dall’infermiere e confrontare tali numeri con quelli riguardanti le complicanze rilevate nel periodo successivo all’introduzione della procedura di stoma siting. METODI: Studio osservazionale retrospettivo monocentrico presso le U.U.O.O. di Chirurgia generale e Urologia nell’Ospedale San Paolo dell’ASST Santi Paolo e Carlo di Milano. Campione di convenienza composto da pazienti sottoposti a confezionamento di una stomia enterale e urinaria. RISULTATI: Sono stati reclutati 264 pazienti. Il 51,1% ha manifestato complicanze stomali; il 42,9% aveva effettuato lo stoma siting il 61,5% no. Le complicanze più frequenti sono state le alterazioni cutanee peristomali (29,9%); la differenza di numero tra i singoli tipi di complicanze nei due gruppi è clinicamente rilevante. CONCLUSIONI: Lo stoma siting è una procedura di competenza infermieristica che, se ben eseguita, porta alla riduzione delle complicanze stomali. È responsabilità dell’infermiere garantire a ciascun paziente sottoposto a confezionamento di stomia la corretta esecuzione del disegno stomale, ogni volta che le condizioni del quadro clinico lo consentono.

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Impact of Preoperative Stoma Site Marking on Morbidity and Mortality in Patients with Colorectal Perforation: A Nationwide Retrospective Cohort Study

et al. 2023

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Background Preoperative stoma site marking reduces the incidence of complications from elective surgery. However, the impact of stoma site marking in emergency patients with colorectal perforation remains unclear. This study aimed to assess the impact of stoma site marking on morbidity and mortality in patients with colorectal perforation who underwent emergency surgery. Methods This retrospective cohort study used the Japanese Diagnosis Procedure Combination inpatient database from April 1, 2012, to March 31, 2020. We identified patients who underwent emergency surgery for colorectal perforation. We compared outcomes between those with and without stoma site marking using propensity score matching to adjust for confounding factors. The primary outcome was the overall complication rate, and the secondary outcomes were stoma-related, surgical, and medical complications and 30-day mortality. Results We identified 21,153 patients (682 with stoma site marking and 20,471 without stoma site marking) and grouped them into 682 pairs using propensity score matching. The overall complication rates were 23.5% and 21.4% in the groups with and without stoma site marking, respectively (p = 0.40). Stoma site marking was not associated with a decrease in stoma-related, surgical, or medical complications. The 30-day mortality did not differ significantly between the groups with and without stoma site marking (7.9% vs. 8.4%, p = 0.843). Conclusions Preoperative stoma site marking was not associated with a reduction in morbidity and mortality in patients with colorectal perforation who underwent emergency surgery.

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The effect of preoperative stoma site marking on risk of stoma-related complications in patients with intestinal ostomy—protocol of a systematic review and meta-analysis

Cited by 13 publications

References 36 publications

A study on patterns, indications, and complications of an enteric stoma

A study on patterns, indications, and complications of an enteric stoma

Le complicanze stomali prima e dopo l’introduzione dello stoma siting effettuato dall’infermiere: uno studio retrospettivo

Impact of Preoperative Stoma Site Marking on Morbidity and Mortality in Patients with Colorectal Perforation: A Nationwide Retrospective Cohort Study

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