Indications for temporary stoma creation and early outcome of stoma closure at University of Dodoma teaching hospitals
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Date
2023
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Abstract
Background
There are many published studies which focused on indications of temporary stoma
creation as well as predictors of complications following stoma closure. Despite
stoma closure being commonly performed procedure in our local settings, yet postoperative complications as well as underlying predictors for those complications are
inadequately addressed. Therefore, this study analyses on the indications for stoma
creation and early outcome of stoma closure. It also explores the relationship
between the indications for stoma creation and early outcomes of stoma closure.
Objective
The aim of this study was to determine the indications for temporary stoma creation
and early outcome of stoma closure.
Methodology
The study was prospective, analytical study done UDOM teaching hospitals from
June 2021 to August 2022. The structured questionnaire was used as a tool for data
collection. The information was obtained from patients, case notes or register book.
Convenient sampling technique was used to select clients. Clavien-Dindo tool was
used for grading severity of post-operative complications, chi-square, binary and
multivariate logistic regression were used to establish association between predictor
and outcome variables. SPSS was used for analysis.
Results
A total of 194 subjects were enrolled in this study. There were 140 males (72.2%)
and 54 females (27.8%) with male to female ratio of 3:1. Colostomy was the leading
type of stoma created 133(68.6%), followed by ileostomy 61(31.4%). Commonest
indications for colostomy were sigmoid volvulus 75(56.4%) and colo-rectal
carcinoma 43(32.3%). Ileostomy was commonly indicated in enteric perforation
24(39.4%) and ileal trauma 20(32.8%).
Overall post-stoma closure complications were noted in 78(40.2%), colostomy
contributed 60(30.9%) and ileostomy 18(9.3%). The noted post-operative
complications were deep and organ/space SSI 52(26.8%), anastomotic leak and
enterocutaneous fistula 21(10.8%) and intestinal obstruction 05(2.6%). ClavienDindo tool showed 78(40.2%) unfavorable and 08(4.1%) favorable outcomes.
Multivariate logistic regression showed hypo-albuminemia (p=0.002) a significant
early outcome predictor of stoma closure.
Conclusion
Hypo-albuminemia was shown to be important prognostic indicator for
complications following stoma closure. The stomas were commonly indicated in
sigmoid volvulus and enteric ileal perforation, and predominant post stoma closure
complications were surgical site infection.
Description
Dissertation (MSc Medicine)
Keywords
Stoma, Temporary Stoma, Stoma Creation, Teaching Hospitals, University of Dodoma, Stoma Closure
Citation
Simba, K. (2023). Indications for temporary stoma creation and early outcome of stoma closure at University of Dodoma teaching hospitals (Master's Dissertation)