2001, Number 3
Complication of enterostomies. Review of 267 stomas
Núñez GMA, Marroquin GRM, Durán RO, Lua RTJ, Hermosillo SJM, Muciño HI, Medina MCO, Anaya PR, González OA
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Language: Spanish
References: 18
Page: 148-153
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ABSTRACT
Antecedents: As a rule, enterostomies are considered a technically simple procedure, however, morbidity and mortality range from 10 to 60% and from 1 to 5%, respectively. The higher values correspond to those obtained under adverse conditions due to acute pathologies and emergency surgery.Objective: To identify the frequency and type of complications associated to a consecutive series of cases and their possible effect on the mortality rate. Design: Prospective, observational, non-randomized study.
Setting: Third level health care hospital.
Patients and methods: Consecutive patients in whom an ostomy was performed between March 1995 and November 1998. The cases were evaluated daily during 60 days or until death of the patient to identify early complications of the procedure(s). Complications were divided in clinical and surgical. Mortality was divided according to non-surgical causes and those secondary to the surgery and, among these, those directly attributable to complications of the stoma(s). Results are expressed in percentage of frequency, averages, and ranges.
Results: A total of 208 patients were studied with 267 stomas, of which 84.13% were due to acute pathology and emergency surgery. The gender ratio was similar. Seventy-four percent (154) of the stomas corresponded to the colon in any of its portions and 26% (54 cases) corresponded to the small intestine, from the duodenum to the ileum. Inflammatory diseases or neoplastic complications of the colon were the most frequent entities requiring an ostomy. For the small intestine, the pathologies were necrosis due to mechanical obstruction or vascular deficiency. Morbidity reached 30% and the most frequent complication was peristomal infection, which occurred in a third of the complicated cases. Mortality attributed to complications of the stoma was of 5/208 cases (2.4%). Noteworthy was the higher frequency of complications when the ostomies were performed through emergency surgery.
Conclusion: Most ostomies were due to colonic pathology; regarding the proximal digestive tract there were duodenostomies and jejunostomies. Morbidity was high (30%), 44 patients had to be reoperated to handle stoma complications, but the corresponding mortality was of only 2.4%.
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