The Frequency of Stoma-Related Readmissions After Emergency and Elective Ileostomy Formation: The Leicester Experience

Abstract

Background Approximately 9,000 patients undergo ileostomy formation each year in England. This includes those formed in both the elective and emergency settings. Recent studies have indicated a stoma-related complication rate of up to 83%.The aim of the current study was to ascertain the most common indications for ileostomy formation and to determine whether there were differences in the complication rates depending on whether the surgery occurred in the emergency or elective setting. Methods The study was a retrospective audit conducted at the University Hospitals of Leicester. Inclusion criteria were patients who underwent ileostomy formation between January 1 and December 31, 2023. Results The study cohort comprised 97 patients. Eleven of 44 (25.0%) patients in the emergency cohort had stoma-related complications, with their main reasons being high output stomas and bowel obstruction, which is higher compared to the elective patient cohort which had a complication rate of 5/53 (9.4%), with their main reasons being parastomal hernias and stoma prolapse. Ileostomies formed as a result of colorectal malignancy also led to a higher complication rate. Conclusion Our study suggests that ileostomies formed in the emergency setting as well as those formed due to colorectal malignancies had a higher rate of stoma-related complications. Stoma-related complications continue to be a common presentation to the emergency department.

Keywords: colorectal malignancy; emergency colorectal surgery; ileostomy; ileostomy complications; open colorectal surgery; stoma related complications.

Figure 1. Flowchart demonstrating the readmission of patients with stoma-related complications

Figure 2. Kaplan-Meier graph showing stoma-related readmission rates: emergency versus elective