Ileostomy Related Complications

Song, Gi Won; Yu, Chang Sik; Lee, Hae Ok; Kim, Mi Sook; Namgung, Hwan; Lee, Gang Hong; Kim, Hee Cheol; Kim, Jin Cheon

Abstract

PURPOSE: Ileostomy may affect various aspects of life style of the patient. Moreover the complication after ileostomy formation or closure may lower the life quality of the patient. The purpose of this study is to investigate ileostomy related complications and elucidate associated factors.
METHODS
We recruited 103 patients who underwent ileostomy in Asan Medical Center between July 1989 and June 2000. All ileostomies are constructed through the rectus muscle at the right lower quadrant of the abdomen. To mnimize peristomal skin irritation, at least two to three centimeters of the ileum lies above the skin level. We analyzed complications after ileostomy formation in relation to underlying diseases, types and purpose of ileostomy. Also, we analyzed complication after ileostomy closure in relation to underlying diseases, time interval and method of take-down. Results are compared using chi-square test. Statistical significance was assigned to a P value of<0.05.
RESULTS
Complications of ileostomy formation were developed in 17 (16.5%) cases; 8 peristomal dermatitis, 3 wound infection, 2 prolapse, 1 stenosis, 1 perforation, 1 bleeding, 1 high output ileostomy. There was no significant difference of complication rate in relation to underlying diseases, types and purpose of ileostomy. Ileostomy take-down was performed in 55 (53.4%) cases of 103 patients. Complications related with ileostomy take-down were developed in 18 (32.7%) cases; 7 wound infection, 5 intestinal obstruction, 2 incisional hernia, 2 enterocutaneous fistula, 1 anastomosis leakage, 1 bleeding. There was no significant difference of complication rate in relation to time interval or method of take-down. However, complication rate of ileostomy take-down was significantly increased in patient with inflammatory bowel disease.
CONCLUSIONS
Ileostomy formation is simple and safe surgical procedure. We couldn't find any factor affecting the morbidity of ileostomy formation or closure. However, complication rate after ileostomy closure, especially in patient with inflammatory bowel disease, is relatively high.