Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 28;19(1):157.
doi: 10.1186/s12876-019-1070-5.

Indications for and complications of intestinal stomas in the children and adults at a tertiary care hospital in a resource-limited setting: a Tanzanian experience

Alicia Massenga  1   2 , Alfred Chibwae  3   4 , Aloyce A Nuri  3   4 , Merchades Bugimbi  3 , Yasin K Munisi  3 , Ramadhani Mfinanga  3 , Phillipo L Chalya  3
Affiliations

Indications for and complications of intestinal stomas in the children and adults at a tertiary care hospital in a resource-limited setting: a Tanzanian experience

Alicia Massenga et al. BMC Gastroenterol. .

Abstract

Background: An intestinal stoma, though a life-saving procedure on the care of many gastrointestinal conditions, carries significant number of complications. This study describes the common indications, complications, and management of stomas and identifies the factors that are associated with these complications in a tertiary care hospital in Tanzania.

Methods: A cross-sectional study of patients with intestinal stomas was conducted at Bugando Medical Centre (BMC) between July 2016 and June 2017. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study.

Results: A total of 167 patients (M: F = 1.2:1) were enrolled in the study. The mean age at diagnosis was 0.6 ± 1.4 years for children and mean age for adults was 36.7 ± 15.8 years. Anorectal malformation (110, 89.4%) was the most common indication for intestinal stoma formation in children, while bowel perforation (14, 31.8%) was the main indications in adults. The sigmoid colon (137, 82.0%) was the most common anatomical site for stoma formation followed by the ileum (18, 10.8%). Stoma prolapse (18, 41.9%) was the most frequent complication of a stoma, whereas, surgical site infection (9, 34.6%) was the most frequent complication after stoma closure. Thirty five (26.7.%) of the children developed stomal complications, while only 8 (22.2%) of the adults developed complications. The level of training of operating surgeon and timing of surgery were the main predictors of stoma-related complications (p < 0.034 and 0.013), whereas the level of training of the operating surgeon and the type of stoma closure were significantly associated with the complications related to stoma closure (p < 0.001).

Conclusion: The intestinal stomas performed at BMC are associated with various complications, which in turn, become a burden to the patients. The insights observed in the current study may apply to other tertiary hospitals in Tanzania and Africa at large. We suggest that the keystones for improvement and control in the formation and complications of intestinal stomas are the following; colostomy formation should rarely be done in transverse colon, the procedure should be carried out by senior doctors (specialist) or junior doctors under close and direct supervision of the specialists, using proper meticulous techniques, and the need to determine and/or improve techniques for early detection of complications.

Keywords: Complications; Indications; Intestinal stomas; Management; Tanzania.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Post-stoma closure complications
See this image and copyright information in PMC

References

    1. Taylor P. An introduction to stomas: reasons for their formation. Nurs Times. 2005:63–4. - PubMed
    1. Saunders RN, Hemingway D. Intestinal Stomas. Surg Int. 2005:44–7.
    1. Ahmad Zeeshanuddin, Sharma Apoorv, Saxena Pradeep, Choudhary Anuradha, Ahmed Minhajuddin. A clinical study of intestinal stomas: its indications and complications. International Journal of Research in Medical Sciences. 2013;1(4):536. doi: 10.5455/2320-6012.ijrms20131140. - DOI
    1. Nastro P., Knowles C. H., McGrath A., Heyman B., Porrett T. R. C., Lunniss P. J. Complications of intestinal stomas. British Journal of Surgery. 2010;97(12):1885–1889. doi: 10.1002/bjs.7259. - DOI - PubMed
    1. Ahmad QA, Saeed MK, Muneera MJ, Ahmad MS, Khalid K. Indications and complications of intestinal stomas- a tertiary care hospital experience. Biomedica. 2010;26:144–147.

MeSH terms