Stoma-related complications and stoma size – a 2-year follow up
Article first published online: 10 JUN 2009
© 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland
Volume 12, Issue 10, pages 971–976, October 2010
How to Cite
Persson, E., Berndtsson, I., Carlsson, E., Hallén, A.-M. and Lindholm, E. (2010), Stoma-related complications and stoma size – a 2-year follow up. Colorectal Disease, 12: 971–976. doi: 10.1111/j.1463-1318.2009.01941.x
- Issue published online: 10 JUN 2009
- Article first published online: 10 JUN 2009
- Received 13 February 2009; accepted 21 April 2009; Accepted Article online 10 June 2009
- Loop ileostomy;
- enterostomal therapist
Aim The purpose of the study was to prospectively describe stoma configuration and evaluate stoma-related complications and their association with possible risk factors.
Method All elective patients (n = 180) operated on with a formation of colostomy, ileostomy or loop-ileostomy between 2003 and 2005 were included in the study. Follow up took place on the ward postoperatively and five times during 2 years after discharge. On these occasions the diameter and height of the stoma were recorded. Complications such as peristomal skin problems, necrosis, leakage caused by a low stoma, stenosis, granuloma formation, prolapse and peristomal hernia formation were evaluated.
Results Most complications occurred 2 weeks after discharge; 53% of patients with colostomies, 79% with loop-ileostomies and 70% of patients with end-ileostomy had one or more complications. The most common complication was skin problems and it was most common in patients with end-ileostomies (60%) and loop-ileostomies (73%). Postoperatively at ward review, the most common complication was necrosis, which occurred in 20% of patients with a colostomy. Granuloma formation was most frequent in colostomies. Almost all patients with an end-ileostomy and loop-ileostomy with a height lower than 20 mm had leakage and skin problems as had half of the patients with a colostomy height lower than 5 mm.
Conclusion To prevent stoma-related complications, it is important to produce an adequate height of the stoma, with early and regular follow ups and adjustment of the appliance. To work closely in collaboration with the colorectal surgeons is of utmost important to provide feedback and in turn, to improve stoma outcome.