Kizigina Simba2024-03-272024-03-272023Simba, K. (2023). Indications for temporary stoma creation and early outcome of stoma closure at University of Dodoma teaching hospitals (Master's Dissertation)https://repository.udom.ac.tz/handle/20.500.12661/4393Dissertation (MSc Medicine)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.enStomaTemporary StomaStoma CreationTeaching HospitalsUniversity of DodomaStoma ClosureThesis