Analysis of late stomal complications following ostomy surgery

Abstract

Background and aims: This study was aimed to evaluate the late complications of ostomy surgery in a strictly followed patient population of a university hospital.

Material and methods: An actuarial analysis of the complications of 156 patients with permanent ostomies using the life-table method was performed.

Results: The crude and actuarial risks of late stomal complications in 156 patients after a mean follow-up of 8 years were 39 per cent and 59 per cent. The cumulative risk of complications did not differ between the stoma types. Paracolostomy hernia was the most common complication of the colostomy, 27 per cent, retraction of ileostomy, 24 per cent, and intestinal obstruction of urostomy, 28 per cent. Mesenteric fixation was here associated with a lower chance of prolapse (P < 0.025), but the closure of lateral space did not reduce the risk of intestinal obstruction. Skin irritation was more common after a creation of ileostomy than after other stoma creations (P < 0.001). The revisional surgery rate was lower following colostomy than following other stoma formations (P < 0.034). Adaptation to the stoma had occurred in 74% of the patients, but 8 per cent of the patients had intractable symptoms at the time of the analysis.

Conclusion: Ostomy surgery involves a high rate of late complications and there is a small but important subgroup of patients whose quality of life is seriously affected.