Factors that predict complications after construction of a stoma: a retrospective study.

摘要

OBJECTIVE: To find out our incidence of complications of stoma surgery and identify variables that predict outcome. DESIGN: Retrospective study. SETTING: Teaching hospital, Scotland. SUBJECTS: All 121 patients who had 126 stomas constructed during 1996. INTERVENTIONS: Follow up until the end of 1999. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: There were 64 men and 57 women, median age 58 years, range 16-83. Forty-three stomas were constructed for malignancy (34%). Forty-two stomas were raised during emergency operations (33%). Colorectal surgeons created 96 stomas (76%). Sixty-one of 92 potentially reversible stomas were closed (66%). Two patients died (2%) perioperatively. Overall stoma-related morbidity was 68% (n = 85). The rate of major stoma-related complications was 26% (n = 33). Nine major complications resulted in a reoperation rate of 7%. On univariate analysis, age, American Society of Anesthesiologists (ASA) grade, and surgeon's speciality were significant predictive variables of major stomal complications (p < or = 0.002, 0.02, and 0.05 respectively). Multivariate analysis showed that the age of the patient was the only factor that independently influenced the outcome of stoma surgery (p < or = 0.001). CONCLUSIONS: Optimising the perioperative health status of the patients, particularly the elderly, may reduce morbidity. The results also support specialist surgical care of patients undergoing stomal surgery.