Elective vs. Emergency Stoma Surgery Outcomes

Adnan Qureshi, Joanne Cunningham and Anil Hemandas

Department of Surgery, Northampton General Hospital, UK
Department of Cellular Pathology, Milton Keynes University Hospital, UK
Department of General Surgery, Keynes University Hospital, UK

^*Correspondance to: Adnan Qureshi 

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Abstract:

Aim: The aim of this study was to compare general and stoma specific complications in patients having stoma surgery in either an emergency or elective setting during their index hospital admission.
Method: We retrospectively analysed data for all stomas created over the last three years in Milton Keynes University Hospital. This covered the period from January 2013 to January 2016. A full electronic record of patient’s kept by stoma department was used besides demography we analysed the type of stoma i.e. colostomy or ileostomy, indications for the stoma, most common operation, Length of Stay (LOS) and short term complications based on the Clavien-Dindo classification and long term complication on one year follow-up. We compared stoma specific complications, in emergency and elective cohort.
Results: A total of 199 patients had new ostomies created during the three year period. Four patients died during the inpatient stay and these were excluded from the analysis. The total number of stomas created in emergency were 60 and 135 stomas were elective procedures. The male to female ratio was 1:1.01. The average age for the emergency cohort was 6 years older than for the elective cohort. There was statistically significant difference in length of stay between two cohorts. The rate of grade 3 or 4 complications higher in the emergency cohort of patients. Long term complication was also high in patients operated in emergency i.e. 48% compared to 25% for elective patients. Most common long term complication in emergency stoma was parastomal hernia.
Conclusion: Emergency surgery procedures are frequently bowel related. Since the introduction of consultant lead services in UK the outcomes have improved significantly. Similarly we recommend any bowel surgery involving stoma should be done under direct supervision of consultant surgeons to improve long term outcomes.

Keywords:

Parastomal hernia; Stoma surgery; Ileostomy; Ostomies

Cite the Article:

Qureshi A, Cunningham J, Hemandas A. Elective vs. Emergency Stoma Surgery Outcomes. World J Surg Surgical Res. 2018; 1: 1050.