A study of complications of temporary ileostomy in cases of acute abdomen with ileal perforation and obstruction

Authors

  • Chandan Roy Choudhury Department of General Surgery, Medical College Hospital, 88 College Street, Kolkata, West Bengal, India
  • Tshering Doma Bhutia Department of General Surgery, Medical College Hospital, 88 College Street, Kolkata, West Bengal, India
  • Bodhisattva Bose Department of General Surgery, Medical College Hospital, 88 College Street, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-2902.isj20184073

Keywords:

Complications, Ileostomy, Temporary

Abstract

Background: Construction of a gastrointestinal stoma is a frequently performed surgical procedure. Although formation of defunctioning loop ileostomy is usually a straightforward procedure, there is an appreciable complication rate. The purpose of the research was to study the complications, outcome associated with temporary ileostomy and to study the complications related to its closure.

Methods: Institutional based observational study using prospective data collection large ileal perforations covering more than one third of the circumference, or gangrenous change or severe adhesions and old perforations with presence of peritoneal contamination were included in the study. 50 patients were included in the study. Clinical, intra-operative, biochemical parameters with stomal and peristomal complications and tissue histopathology were assessed in the study.

Results: The commonest aetiology for which stoma was performed enteric perforation (44%) whereas perforation was the commonest aetiology for which stoma was performed (64%) apart from gangrene and other aetiologies. The commonest post-operative complication encountered was skin excoriation (64%). Most of the the complications encountered post operatively were statistically significant when correlated with aetiology and duration of presentation.

Conclusions: Although being bothersome, loop ileostomy is still a live saving procedure. Complications of stoma could be managed conservatively with the application of proper user-friendly stoma appliances and it is of paramount importance that ileostomies are properly sited. Before closure of ileostomy it is essential to be careful of operative biopsy report showing non-specific inflammation. Preference of surgeons in the present day to perform ileostomy in emergency setting is increasing.

References

Mealy K, O’Broin E, Donohue J, Tanner A, Keane FB. Reversible colostomy: what is the outcome? Dis Colon Rectum. 1996;39:1227-31.

Londono-Schimmer EE, Leong AP, Phillips RK. Life table analysis of stomal complications following colostomy. Dis Colon Rectum. 1994;37:916-20.

Leenen LP, Kuypers JH. Some factors influencing the outcome of stoma surgery. Dis Colon Rectum. 1989;32:500-4.

Leong AP, Londono-Schimmer EE, Phillips RK. Life table analysis of cstoma complications following ileostomy. Br J Surg. 1994;81:727-9.

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

Roy PH, Sauer WJ, Beahrs OH, Farrow GM. Experience with ileostomies: evaluation of long-term rehabilitation in 497 patients. Am J Surg. 1970;119:77-86.

Wexner SD, Taranow DA, Johanson OB. Loop ileostomy is safe option for fecal diversion. Dis Colon Rectum. 1993;36:349-54.

Sensapati A, Nicholls RJ, Ritchie JK, Tibbs CJ, Hawley PR. Temporary loop ileostomy for restorative proctocolectomy. Br J Surg. 1993;80:628-30.

Hull TL, Kobe I, Fazio VW. Comparison of handsewn with stapled loop ileostomy closures. Dis Colon Rectum. 1996;39:1086-9.

Harris DA, Egbeare D, Jones S, Bejamin H, Woodward A, Foster ME. Complications and mortality following stoma formation. Ann R Coll Surg Eng. 2005;87:427-31.

Phang PT, Hain JM, Prez-Ramirez JJ, Madoff RD, Gemlo BT. Techniques and complications of ileostomy takedown. Am J Surg.1999;177:463-6.

O’Leary DP, Fide CJ, Foy C, Lucarotti ME. Quality of life after low anterior resection with total mesorectal excision and temporary loop ileostomy for rectal carcinoma. Br J Surg. 2001;88:1216-20.

O’Toole GC, Hyland JM, Grant DC, Barry MK. Defunctioning loop ileostomy: a prospective audit. J Am Coll Surg.1999;188:6-2.

Gooszen AW, Geelkerken RH, Hermans J, Lagaay MB, Gooszen HG. Quality of life with a temporary stoma; ileostomy vs colostomy. Dis Colon Rectum. 2000;43:650-5.

Kaider-person O, Person B, Waxner SD. Complications of construction and closure of temporary loop ileostomy. J Am Coll Surg. 2005;201:759-73.

Robertson I, Leung E, Hughes D, Spiers M, Donnelly L, Mackenzie I, et al. Prospective analysis of stoma related complications. Colorectal Dis. 2005;7:279-85.

Sier MF, Oostenbroek RJ, Dijkgraaf MGW, Veldink GJ. Home visits as part of a new care pathway (iAID) to improve quality of care and quality of life in ostomy patients: a cluster‐randomized stepped‐wedge trial. Colorectal Dis. 2017;19(8):739-49.

Andivox T, Bail J, Chio F. Complications of colostomies. Follow-up study of 500 colostomized patients. Ann Chir. 1996;50:252-7.

Bass EM, Del Pino A, Tan A, Pearl RK, Orsay CP, Abcarian H. Does preoperative stoma marking and education by the enterostomal therapist affect outcome? Dis Colon Rectum. 1997;40:440-2.

Duchesne JC, Wang, YZ, Wentraub SL, Boyle M Hunt JP. Stoma complications: a multiviate analysis. Am J Surg. 2002;68:961-6.

Morris DM, Rayburn D. Loop colostomies are totally diverting in adults. Am J Surg. 1991;161:668-71.

Hallbook O, Matthiessen P, Leinskold T, Nystorm PO, Sjodhal R. Satey of the temporary loop ileostomy. Colorectal Dis. 2002;4:361-4.

Safirulla, Mumtaz N, Jan MA, Ahmed S. Complications of intestinal stomas. J Postgrad Med Inst. 2005;19:407-11.

Wexner SD, Taranow DA, Johansen OB, Itzkowitz F, Daniel N, Nogueras J. Loop ileostomy is a safe option for fecal diversion. Dis Colon Rectum. 1993;36:349-54.

Van de Pavoordt HD, Fazio VW, Jagelman DG, Lavery IC, Weakly FL. The Outcome of loop ileostomy closure in 293 cases. Int J Colorectal Dis. 1987;2:214-7.

Phang PT, Hain JM, Perez-Ramirez JJ, Madoff RD, Gemlo BT. Techniques and complications of ileostomy takedown. Am J Surg. 1999;177:463-6.

Chang P, Chun JT, Bell JL. Complex enterocutaneous fistula closure with rectus abdominis muscle flap. South Med J. 2000;93(6):599-602.

Memon ZA, Qureshi S, Murtaza M, Maher M. Outcome of ileostomy closure. Pak J Surg. 2009;25(4).

Amin SN, Memon MA, Armitage NC, Scholfield JH. Defunctioning loop ileostomy and stapled side to side closure has low morbidity. Ann R Coll Surg Engl. 2001;83:246-9.

Edwards DP, Leppington-Clarke A, Sexton R, Herald RJ, Moran BJ. Stoma related complications are more frequent after transverse colostomy than loop ileostomy; a prospective randomized clinical trial. Br J Surg. 2001;88:360-3.

Shellito PC. Complication of abdominal stoma surgery. Dis Colon Rectum. 1988;41:1562-72.

Downloads

Published

2018-09-25

Issue

Section

Original Research Articles