Intestinal Stomas in Abdominal Surgery: Etiological Circumstances, Indications, High Gravity Factors and Complications.

Abstract

This is a retrospective study of 264 intestinal stomas performed in the surgical unit of the Emergency Clinical Hospital "Bagdasar Arseni", Bucharest, within a 7-year period (2015-2021) aiming to evaluate their evolutive complications, risk factors, management and prevention strategies. Material and method. Colostomies: 218 (82.57%) cases, ileostomies 46 (17.43%) cases. Temporary stomas (103 cases or 39.02%) were isolated stomas of discharge in 45 cases and associated with other colorectal procedures in 58 cases. Postoperative complications included general systemic complications in 60 (22.72%) cases and local complications specific to stomas in 84 (31.81%) cases and common to abdominal surgery in 94 (35.60%) cases, which were solved by reoperation in 51 cases, with a reintervention rate of 19.31%. Stoma closures were performed in 34 (33.0%) of the 103 patients with temporary stomas. Of these, 26 (25.24%) patients died in the early postoperative period (< 30 days), the remaining 60 patients refused reintervention or were lost to follow-up. Conclusions. Faecal diversion still represents a therapeutic option for a wide range of benign or malignant digestive or extra-digestive abdominal diseases performed in emergency or scheduled surgeries, mostly for colorectal cancer and its complications.