Stomal Complications

2017 ◽  
pp. 121-141 ◽  
Author(s):  
Sumeet Syan-Bhanvadia ◽  
Siamak Daneshmand
Keyword(s):  
Stomal Complications

scholarly journals Avoidance and Management of Stomal Complications

2013 ◽  
Vol 26 (02) ◽  
pp. 112-121 ◽  
Author(s):  
Michael Kwiatt ◽  
Michitaka Kawata
Keyword(s):  
Stomal Complications

Ileal Conduit and Continent Ileocecal Pouch for Patients Undergoing Pelvic Exenteration: Comparison of Complications and Quality of Life

2011 ◽  
Vol 21 (2) ◽  
pp. 403-408 ◽  
Author(s):  
Dirk Michael Forner ◽  
Björn Lampe
Keyword(s):  
Quality Of Life ◽  
Urinary Diversion ◽  
Pelvic Exenteration ◽  
Ileal Conduit ◽  
Short Form ◽  
Complication Rates ◽  
Stomal Complications ◽  
Short Form Health

Objectives:Creating a continent urinary pouch has become an alternative to the ileal conduit for patients undergoing exenteration for advanced gynecologic malignancies. The objective of this study was to compare clinical outcomes for the 2 methods.Methods:In this retrospective study, we compared intraoperative and postoperative complications and quality-of-life scores for the modified ileocecal pouch and the ileal conduit in anterior or total pelvic exenteration.Results:In 33 of 100 patients, an ileal pouch (IP) was created; the other 67 were treated by an ileal conduit (IC). Creating an IP prolonged the exenterative procedure by 97 minutes compared to an IC (IC, 453 minutes vs IP, 550 minutes;P= 0.009). Overall complication rates were similar, but patients with an IP had significantly more complications of urinary diversion (48%) than patients with an IC (31%;P= 0.03). Follow-up showed urinary loss and frequency of micturition to be comparable, but in patients with an IP, surgery for stomal complications (n = 2) and treatment of bladderstones were necessary more frequently (n = 3). Quality of life according to the 12-item Short Form Health Survey questionnaire was similar in both groups.Conclusion:A continent IP is an alternative to the IC in cases of pelvic exenteration. Early complications are more frequent with an IP than with an IC. The mode of urinary diversion has little influence on the quality of life in patients with advanced genital cancer.

Management of the Continent Cutaneous Stomal Complications

2012 ◽  
Vol 7 (4) ◽  
pp. 294-301 ◽  
Author(s):  
Sumeet Syan-Bhanvadia ◽  
Siamak Daneshmand
Keyword(s):  
Stomal Complications

Prevention of stomal complications

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20745-e20745
Author(s):  
M. V. Phadke
Keyword(s):  
Wound Healing ◽  
Deleterious Effect ◽  
Rectus Sheath ◽  
High Rate ◽  
Tube Lumen ◽  
Stomal Complications ◽  
Round Opening ◽  
Bacterial Migration ◽  
A Minor

e20745 Background: Ileostomy/Colostomy operations are associated with a high rate of infections and complications resulting in increased morbidity, mortality and litigation. Pathogenesis of each complication and role of Nature was observed. Technique of stomal maturation was modified. Surgeon must maintain control over the stoma at all times. Primary maturation of stoma is unnecessary and potentially harmful. Opening stomal lumen in O.R. is unscientific and allows bacteria to contaminate stomal and main wounds. Methods: Concept was evolved by serendipity in April 1986. Since then it has been used on all patients requiring an Ileostomy or Colostomy. Bacterial migration is prevented by keeping the lumen obstructed. Iatrogenic obstruction of small/large intestine has no deleterious effect on post-operative course. Obstructed bowel is brought out of opening at proposed site of stoma. Mesenteric corner of obstructed stoma is always above the skin. Anti-mesenteric surface is pulled out till the anti-mesenteric corner becomes the apex of a conical stoma. Serosa is sutured to a round opening in the rectus sheath. Stoma is covered by an appliance with a transparent pouch. Peristalsis starts in about 48–72 hours. When obstructed stoma bulges, it is opened with electrocautery as a minor bedside procedure. Diet is started. Peristalsis pushes mucosal cuff which protrudes, everts and auto-grafts over angiogenesis. This is based on Delayed-Primary (DP) wound healing. Mucosal cuff comes in contact with dermis of skin opening at stomal site completing Self-Maturation (SM). During SM, mucosal tube separates from serosal tube. Peristalsis continues to exert its effect on serosal tube but not on mucosal tube. Lumen of stoma remains concentric. Results: 65 Colostomies and 15 Ileostomies were performed using DPSM technique. Infection and complications were prevented. Minor complications were handled easily. Patient satisfaction was excellent. Conclusions: Primary maturation of stoma is unnecessary and potentially harmful and should be replaced by DPSM. It can be performed in all types of stoma construction, end or loop, temporary or permanent. It prevents infection and complications in all patients. No significant financial relationships to disclose.

Lessons Learned From Stomal Complications in Children With Cutaneous Catheterizable Continent Stomas

2006 ◽  
Vol 175 (5) ◽  
pp. 1904-1904
Author(s):  
A. Baroawi ◽  
M. de Valdenebro ◽  
P.D. Furness ◽  
M.A. Koyle
Keyword(s):  
Lessons Learned ◽  
Stomal Complications

scholarly journals Late stomal complications and their surgical correction

2012 ◽  
Vol 93 (4) ◽  
pp. 602-606
Author(s):  
M V Timerbulatov ◽  
A A Ibatullin ◽  
F M Gaynutdinov ◽  
A V Kulyapin ◽  
L R Aitova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Russian Federation ◽  
Parastomal Hernia ◽  
Surgical Techniques ◽  
Russian Federation Patent ◽  
Surgical Correction ◽  
New Methods ◽  
Stomal Complications ◽  
Reconstructive Operations

Aim. To conduct a detailed analysis of the causes of development of late stomal complications, to determine the indications for surgical correction, to evaluate the effectiveness of new methods of surgical treatment. Methods. Conducted was an analysis of the causes of late stomal complications in 141 patients with a stoma of the colon. Results. A parastomal hernia was diagnosed in 44 (31.2%), prolapse - in 29 (20.6%), stricture - in 9 (6.4%) patients. Introduced into practice were new methods of surgical correction of complicated stomas. Parastomal hernia was detected in 44 (31.2%) patients - 26 (59.1%) females and 18 (40.9%) males, all patients with this complication were older than 50 years, the age group 71-80 years included 43.5% of patients. Since 2005 performed were 17 reconstructive operations for parastomal hernias (Russian Federation patent №2406454 and №2395238). Stoma prolapse was observed in 29 (20.6%) patients, 10 cases - in patients aged 71 to 80 years. Most often this complication developed in patients with double-barreled transverse stomas - in 10 (76.9%) of 13 patients. 4 patients underwent surgery due to prolapse. Stoma stricture was diagnosed in 9 (6.4%) patients. In 7 patients with a stoma stricture in the early postoperative period registered was festering of the parastomal wound (4 cases), marginal necrosis of the stoma (2 cases), and stoma retraction (1 case). Correction with the use of stents for the prevention of recurrence (Russian Federation patent №2357681) was conducted in all cases. The so-called «lock-stoma» was diagnosed in 16.3% of cases (23 patients). Although this condition does not belong to stomal complications in its pure form, however in most cases it causes the inability to use the incontinence bag, reducing the quality of life. Conclusion. Despite the inevitability of the development of parastomal complications, provided proper surgical techniques can either prevent or delay their appearance; reconstructive operations for complicated stomas, conducted by moving the stoma to a new place with retroperitoneal conduction makes it possible to obtain satisfactory results, significantly improve the quality of life that promotes full social adaptation of stomal patients.

A randomised clinical study on the postoperative use of two commercially available ostomy seals (STEPS study)

2021 ◽  
Vol 19 (Sup4a) ◽  
pp. S21-S32
Author(s):  
Liz Harris ◽  
George Skountrianos ◽  
Colleen Drolshagen
Keyword(s):  
Clinical Study ◽  
Economic Impact ◽  
Resource Use ◽  
Healthcare Resource ◽  
Skin Barrier ◽  
Severity Index ◽  
Healthcare Resource Use ◽  
Open Label ◽  
Stomal Complications ◽  
Study Results

Background: Ostomy seals are an accessory product used to enhance the fit of an ostomy skin barrier. Research into the clinical and health economic impact of ostomy seals is limited. Aims: To evaluate the clinical and economic impact of two commercially available ostomy seals when used on patients with a newly created stoma, 1–2 days postoperatively. Methods: A non-powered, exploratory, multi-centre, two-country, open-label, parallel-randomised clinical study was conducted. Patients were randomised to the Dansac TRE Seal (Dansac A/S, Fredensborg, Denmark) or the Coloplast Brava Protective Seal (Coloplast A/S, Humlebæk, Denmark) and were followed up to 9 weeks after the stoma was created. Clinical outcomes were primarily assessed via the validated Pittman Ostomy Complication Severity Index (OCSI). Economic outcomes were assessed via the collection of stoma-related healthcare resource use. Satisfaction measures with seal performance were also collected. Findings: In total, 42 participants were enrolled (20 TRE and 22 Brava). Lower peristomal skin complication (PSC) incidence (TRE 50.0% vs Brava 72.7%; p=.16), greater PSC resolution (TRE 70.0% vs Brava 43.8%; p=.22) and slightly less severe peristomal and stomal complications (average OCSI score TRE 2.2 vs Brava 3.4; p=.19) were observed in the TRE group. On average, participants in the TRE group used 1.3 seals per day compared with 1.4 seals per day for those in the Brava group (p=.83). Lastly, 100% of clinicians and 100% of patients reported positive satisfaction with the overall performance of TRE and Brava seals. Conclusions: Participants randomised to TRE seal were observed to have lower PSC incidence, greater PSC resolution and slightly less severe peristomal and stomal complications relative to participants using the Brava seal. No substantive differences were found in stoma-related healthcare resource use. Positive satisfaction was noted for both ostomy seals. Study results provided valuable insights into the postoperative use of ostomy seals for individuals with newly created ostomies.

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