Presented to meetings of the Association of Surgeons of Great Britain and Ireland, Glasgow, UK, May 2009, the Association of Coloproctologists of Great Britain and Ireland, Harrogate, UK, June 2009, and the European Society of Coloproctology, Prague, Czech Republic, September 2009; and published in abstract form as Colorectal Dis 2009; 11(Suppl 1): 37 and Colorectal Dis 2009; 11(Suppl 2): 36
Complications of intestinal stomas †
Article first published online: 24 SEP 2010
Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 97, Issue 12, pages 1885–1889, December 2010
How to Cite
Nastro, P., Knowles, C. H., McGrath, A., Heyman, B., Porrett, T. R. C. and Lunniss, P. J. (2010), Complications of intestinal stomas . Br J Surg, 97: 1885–1889. doi: 10.1002/bjs.7259
- Issue published online: 4 NOV 2010
- Article first published online: 24 SEP 2010
- Manuscript Accepted: 13 JUL 2010
Stomal complications are prevalent and associated with considerable morbidity. This study examined the incidence and potential risk factors for their development.
The time of onset and presence of ten specific complications were recorded for patients with an intestinal stoma over 10 years at two urban hospitals. A database was established with 20 explanatory variables (such as common medical co-morbidities) derived from the stomatherapy and medical records. Univariable and multivariable analyses were performed to identify potential risk factors for the development of complications.
Some 1216 patients (mean age 64 years) with a minimum of 2 years' follow-up were included, of whom 544 (44·7 per cent) underwent surgery for malignancy and 647 (53·2 per cent) had a colostomy formed. There were 1219 complications in total; 807 major complications (excluding excoriation and slough) occurred in 564 patients (46·4 per cent), of which the commonest was parastomal hernia (171, 14·1 per cent). On multivariable analysis, musculoskeletal co-morbidity (odds ratio (OR) 1·79, 95 per cent confidence interval 1·05 to 3·07; P = 0·032), cancer (OR 1·48, 1·13 to 1·93; P = 0·004) and high American Association of Anesthesiologists score (OR = 3·80, 2·14 to 6·75; P < 0·001) were associated with an increased risk of complications. Preoperative siting was associated with a reduced risk (OR 0·59, 0·39 to 0·90; P = 0·014).
Intestinal stomal complications are common, occurring in almost half of patients. There are certain irremediable risk factors, allowing appropriate preoperative counselling. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.