Surgical complications of colostomies

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Hazem Ben Ameur
Nejmeddine Affes
Haitham Rejab
Bassem Abid
Salah Boujelbene
Rafik Mzali
Mohamed Issam
Mohamed Issam Beyrouti

Abstract

Background: The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. Aim: reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence.

Methods
: A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication.

Results
: Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial.

Conclusion: Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

Keywords:

Colostomy, complications, prolapse, necrosis, retraction, suppuration, stenosis, parastomal hernia

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