Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2001, Issue 3


Núñez GMA, Marroquin GRM, Durán RO, Lua RTJ, Hermosillo SJM, Muciño HI, Medina MCO, Anaya PR, González OA
Complication of enterostomies. Review of 267 stomas
Cir Gen 2001; 23 (3)

Language: Español
References: 18
Page: 148-153
PDF: 4. Kb.


Full text




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%.


Key words: Enterostomies, early complication, colon, morbidity, mortality.


REFERENCIAS

  1. Shellito PC. Complications of abdominal stoma surgery. Dis Colon Rectum 1998; 41: 1562–72.

  2. Corman ML. Intestinal stomas. In: Corman ML. Colon and Rectal Surgery. 4th ed. Philadelphia-New York, USA. Lippincott-Raven 1998; Cap.31: 1264-1348.

  3. Riesener KP, Lehnen W, Höfer M, Kasperk M, Braun JC, Schumpelick V. Morbidity of ileostomy and colostomy closure impact of surgical technique and perioperative treatment. World J Surg 1997; 21: 103-8.

  4. Hellman J, Lago CP. Dermatologic complications in colostomy and ileostomy patients. Int J Dermatol 1990; 29: 129-33.

  5. Allen-Mersh TG, Thompson JFS. Surgical treatment of colostomy complications. Br J Surg 1988; 75: 416-8.

  6. Stothert JC Jr, Brubacher L, Simonowitz DA. Complications of emergency stoma formation. Ann Surg 1982; 117: 307-9.

  7. Abcarian H, Pearl RK. Stomas. Surg Clin North Am 1988; 68: 1295-1305.

  8. Del Pino A, Cintron JR, Orsay CP, Pearl RK, Tan AB, Abcarian H. Enterostomal complications: are emergently created enterostomas at greater risk? Am Surg 1997; 63: 653-6.

  9. Cheung MT. Complications of an abdominal stoma: an analysis of 322 stomas. Aust N Z J Surg 1995; 65: 808-11.

  10. Leong APK, Londono-Schimmer EE, Phillips RKS. Life-table analysis of stomal complications following ileostomy. Br J Surg 1994; 81: 727-9.

  11. Carlsen E, Bergan A. Technical aspects and complications of end–ileostomies. World J Surg 1995; 19: 632-6.

  12. Chandler JG, Evans BP. Colostomy prolapse. Surgery 1978; 84: 577-82.

  13. Feinberg SM, McLeod RS, Cohen Z. Complications of loop ileostomy. Am J Surg 1977; 153: 102-7.

  14. Metcalf AM, Dozois RR, Beart RW Jr, Kelly KA, Wolff BG. Temporary ileostomy for ileal pouch-anal anastomosis: function and complications. Dis Colon Rectum 1986; 29: 300-3.

  15. Belmonte C, Klas JV, Perez JJ, Wong WD, Rothenberger DA, Goldberg SM, et al. The Hartmann procedure. First choice or last resort in diverticular disease? Arch Surg 1996; 131: 612-7.

  16. Ramia JM, Ibarra A, Alcalde J. Resection of and endo-colostomy stricture with a circular stapling device. Br J Surg 1996; 83: 1581.

  17. Cubertafond P, Gainant A, Barbier J, Coste G. Colostomies: indications et complications. A propos d’une analyse de 1142 cas. Chirurgie 1985; 111: 331-41.

  18. Pearl RK, Prasad ML, Orsay CP, Abcarian H, Tan AB, Melzl MT. Early local complications from intestinal stomas. Arch Surg 1985; 120: 1145-7.






>Journals >Cirujano General >Year 2001, Issue 3
 

· Journal Index 
· Links 






       
Copyright 2019