A Study of Intestinal Stomas: It's Indications and Complications

Background: Stomas may be ‘permanent’ which are created indefinitely or ‘temporary’ which can be closed later. In case of intestinal perforation and obstruction, it is always a difficult decision for a surgeon to create a stoma for fecal diversion. Intestinal stoma surgery is lifesaving procedure, as a surgeon we should cope with emotional and functional impairment that a patient undergoes intestinal stoma surgery particularly in the early postoperative period. This is why any recommendation and suggestions in the management of stoma, or change in surgical technique, which seem to have merit should be accepted by patient, attenders, nursing staff and surgeon and hence is the need for study on indications & complications of intestinal stomas and their management. Objectives: To study indications and various complications of intestinal stomas. Methodology: From November 2018 to June 2020, 61 patients from the general surgery, surgical gastroenterology, and pediatric surgery departments of RD Gardi Medical College Ujjain participated in the study. The study aimed to determine the many kinds of intestinal stomas and their indications, as well as the different consequences that were experienced and how they may be reduced and better controlled. The study included all patients undergoing stoma creation, male and female, up to the age of 70. Results: The age group of 30 to 40 years old had the highest number of cases. It demonstrates a highly significant correlation (p <0.01) between the patient’s age and the stoma construction. Most people in the 30- to 40-year-old age range are at risk of having a loop ileostomy. 61 patients’ lengths of hospital stays were examined; the majority (72.1%) spent between 10 and 20 days in the hospital. Skin excoriations were the most frequent consequence seen during stoma construction (45.9%), followed by laparotomy wound infection (13.1%). It demonstrates a substantial correlation (p <0.05) between the indication for a stoma and difficulties resulting from its construction. Conclusion: Most of the patients underwent stoma as an emergency procedure rather than elective procedure. Duration of hospital stay was approximately 10-20 days, even prolonged when complications occurred. The most common indications for stoma construction were hollow viscous perforation and enteric fever. Most common stoma constructed was loop ileostomy followed by end ileostomy. There is high incidence of peristomal complication related to that. The complications are better managed with proper preoperative planning and effective stoma care in post-operative period.