{"title":"Early postoperative complications of elective versus emergency stoma creation: a tertiary academic center experience.","authors":"Bin Traiki Thamer, Fayez Aldarsouni, Razan AlRabah, Hassan Aloraini, Esraa Altawil, Doaa Alfraidy, Sulaiman Alshammari, Noura Alhassan, Khayal Alkhayal","doi":"10.25270/wmp.23102","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Stoma creation is standard in general surgery, yet complication rates remain high.</p><p><strong>Purpose: </strong>This study investigated the incidence and risk factors for early postoperative stoma complications in elective vs emergency surgery.</p><p><strong>Methods: </strong>All patients who underwent stoma creation between June 2015 and November 2020 were retrospectively reviewed and analyzed. Patients were divided into 2 groups based on the surgery type: elective vs emergency.</p><p><strong>Results: </strong>A total of 375 patients were included in this study. Two hundred fifty-three patients (67.5%) underwent elective stoma creation, while 122 (32.5%) underwent stoma creation during an emergency surgery. In the emergency group, white blood cell, blood urea nitrogen, and creatinine levels were statistically significantly higher (P = .001, .001, and .002, respectively). Albumin levels were statistically significantly lower in the emergency group (P = .001). The mean Emergency Surgery Score was 5.17 ± 2.73 in the emergency group compared to 4.4 ± 2.44 in the elective group (P = .006). Colorectal cancer was the most common cause of stoma creation in both groups. In terms of stoma creation, colostomy was statistically significantly more common in the emergency group (59%, P = .001), compared to ileostomy in the elective group (58.9%, P = .001). Complications were observed in 135 of all patients (36%). Necrosis was statistically significantly more common in emergency cases (9.9%, P < .001).</p><p><strong>Conclusion: </strong>Surgeons should strive to optimize the patient's condition prior to the operation and, if possible, perform stoma marking or involve a stoma nurse in the operating room to select the most suitable site. In high-risk patients, where complications are more likely, the use of a stoma should be minimized and definitive management should always be pursued if feasible.</p>","PeriodicalId":23741,"journal":{"name":"Wound management & prevention","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wound management & prevention","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25270/wmp.23102","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Stoma creation is standard in general surgery, yet complication rates remain high.
Purpose: This study investigated the incidence and risk factors for early postoperative stoma complications in elective vs emergency surgery.
Methods: All patients who underwent stoma creation between June 2015 and November 2020 were retrospectively reviewed and analyzed. Patients were divided into 2 groups based on the surgery type: elective vs emergency.
Results: A total of 375 patients were included in this study. Two hundred fifty-three patients (67.5%) underwent elective stoma creation, while 122 (32.5%) underwent stoma creation during an emergency surgery. In the emergency group, white blood cell, blood urea nitrogen, and creatinine levels were statistically significantly higher (P = .001, .001, and .002, respectively). Albumin levels were statistically significantly lower in the emergency group (P = .001). The mean Emergency Surgery Score was 5.17 ± 2.73 in the emergency group compared to 4.4 ± 2.44 in the elective group (P = .006). Colorectal cancer was the most common cause of stoma creation in both groups. In terms of stoma creation, colostomy was statistically significantly more common in the emergency group (59%, P = .001), compared to ileostomy in the elective group (58.9%, P = .001). Complications were observed in 135 of all patients (36%). Necrosis was statistically significantly more common in emergency cases (9.9%, P < .001).
Conclusion: Surgeons should strive to optimize the patient's condition prior to the operation and, if possible, perform stoma marking or involve a stoma nurse in the operating room to select the most suitable site. In high-risk patients, where complications are more likely, the use of a stoma should be minimized and definitive management should always be pursued if feasible.