INDICATIONS AND COMPLICATIONS OF INTESTINAL STOMA FORMATION

Abstract

Objective:
To determine the frequency of indications and complications of intestinal stoma formation in patients undergoing stoma surgery.
Methodology:
A descriptive cross-sectional study was carried out in the Department of General Surgery, JPMC, Karachi, Pakistan, between April 2022 and April 2023. A total of 120 participants, aged 20–60 years with ASA classifications I–III, were enrolled through non-probability purposive sampling. Postoperative complications, including skin excoriation, stomal bleeding, retraction, wound infections, and parastomal hernia, were documented. Statistical analysis was conducted using SPSS version 26.0, with results analyzed at a 5% level of significance.
Results:
The participants had an average age of 39 years, with a standard deviation of 12.6 years among them 60.8% were male and 39.2% female. Abdominal trauma was noted in 21.8% of younger patients and 28.6% of older ones (p=0.408). Similarly, abdominal sepsis occurred in 10.7% of elective cases versus 3.3% in emergency cases (p=0.139), and anastomotic leaks were nearly identical at 3.6% for elective and 3.3% for emergency procedures (p=0.660). However, postoperative complications varied, with intestinal obstruction being significantly higher in older patients (16.7% compared to 5.1% in younger patients, p=0.042). Additionally, parastomal hernias were more common in older patients, showing a borderline difference (9.5% vs. 1.3%, p=0.050).
Conclusion:
The research highlights gastrointestinal cancers and abdominal injuries as the primary reasons for intestinal stoma formation, with most cases stemming from emergency surgeries. Complications like intestinal blockage, skin irritation, and stoma retraction were more prevalent, particularly in older individuals. These findings underscore the importance of careful planning before surgery and attentive care afterward to reduce risks.
Keywords:
Complications, Enteric perforation, Intestinal stoma, Stoma formation indications, Wound infection