Jayarajah Umesh, Samarasekara Asuramuni M P, Samarasekera Dharmabandhu N
Department of Surgery, Faculty of Medicine, University of Colombo, Kynsey Road, P.O. Box 271, Colombo 8, Sri Lanka.
BMC Res Notes. 2016 Dec 5;9(1):500. doi: 10.1186/s13104-016-2304-z.
Complications of ostomy significantly affect the quality of life of ostomates. There is little evidence on the rate of long-term complications in ostomates, especially from the developing countries which include Sri Lanka. This study was aimed to describe the long-term complications of enteral ostomies and their contributory factors.
A retrospective analysis was carried out on 192 patients who underwent ostomy creation over a period of 5 years. Data on type of complications, age, sex, type of ostomy, type of surgery and perioperative care by enteric stoma therapist were gathered. Associations were established using Chi square test and multiple logistic regression.
Out of 192 patients, only 146 patients presented regularly for follow up. The mean follow up duration was 28 months (range: 3-183). Around 34.2% developed surgical long-term complications related to the ostomy. Common complications were prolapse (n = 24, 16.4%), skin excoriation (n = 22, 15.1%) and parastomal hernia (n = 14, 9.6%). Overall complication rate was significantly less in loop ostomies (p < 0.05) and defunctioning ostomies (p < 0.05). Skin excoriation was significantly high in males (p < 0.05) and in ileostomies (p < 0.001). Parastomal hernia was commoner in end ostomies (p < 0.05). Perioperative care by enteric stoma therapist reduced the overall and specific complications (p < 0.001).
The overall complication rate in our cohort of patients was 34.2%. The perioperative care of a stoma therapist may be very effective in preventing complications particularly in a setting with limited resources.
造口并发症严重影响造口者的生活质量。关于造口者长期并发症发生率的证据很少,特别是来自包括斯里兰卡在内的发展中国家。本研究旨在描述肠造口的长期并发症及其相关因素。
对5年内接受造口手术的192例患者进行回顾性分析。收集并发症类型、年龄、性别、造口类型、手术类型以及肠造口治疗师的围手术期护理等数据。采用卡方检验和多元逻辑回归建立关联。
192例患者中,只有146例定期进行随访。平均随访时间为28个月(范围:3 - 183个月)。约34.2%的患者出现与造口相关的手术长期并发症。常见并发症为脱垂(n = 24,16.4%)、皮肤擦伤(n = 22,15.1%)和造口旁疝(n = 14,9.6%)。袢式造口(p < 0.05)和非功能性造口(p < 0.05)的总体并发症发生率显著较低。男性(p < 0.05)和回肠造口(p < 0.001)的皮肤擦伤发生率显著较高。造口旁疝在端式造口中更为常见(p < 0.05)。肠造口治疗师的围手术期护理降低了总体和特定并发症的发生率(p < 0.001)。
我们队列患者的总体并发症发生率为34.2%。造口治疗师的围手术期护理在预防并发症方面可能非常有效,特别是在资源有限的情况下。