J Korean Soc Coloproctol.
2008 Apr;24(2):83-90. 10.3393/jksc.2008.24.2.83.
The Complications of Stoma Take-down
- Affiliations
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- 1Colorectal Clinic, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. jckim@amc.seoul.kr
- KMID: 1479320
- DOI: http://doi.org/10.3393/jksc.2008.24.2.83
Abstract
- PURPOSE
The study aimed to investigate the complications accompanying stoma take-down and to elucidate the significant factors associated with complications. METHODS: We recruited 341 patients who underwent stoma take-down in our hospital between January 2000 and December 2005. Data on various complications during this procedure, i.e., wound infection, prolonged ileus, and anastomotic leakage, were collected with respect to patient- and operation-associated parameters. RESULTS: Complications of stoma take-down developed in 72 (21.1%) patients: 53 (20.3%) patients in a loop ileosotmy, 10 (21.3%) patients in a loop colostomy, and 9 (27.3%) patients in a Hartmann colostomy, The overall complication rate was significantly associated with the urgency of the primary operation (elective vs. emergent, 17.8% vs. 29%, P=0.017), and with the operation time (< or =80 min vs. > 80 min, 16.5% vs. 29.3%, P=0.005). Among the complications, ileus developed in 46 (13.5%) patients, wound infection in 17 (5.0%) patients, and anastomotic leakage in 5 (1.5%) patients. Wound infection was related to the type of stoma between a loop ileostomy and a Hartmann colostomy (3.5% vs. 12.1%; P=0.014), but no other factors were associated with other complications. CONCLUSIONS: There were significant differences in overall complications in relation to urgency of the primary operation and the operation time, but there was no statistical difference in complications between a loop ileostomy and a loop colostomy take- down groups. The significance of these factors appears to be reduced with accurate surgical technique and patient care.
