Muhammad Shahid Alam, Khalid Masood Gondal, Humayun Siddique, Yar Muhammad.
Outcome of early closure of temporary stoma.
Ann King Edward Med Uni Jan ;21(4):214-8.
Introduction: A stoma is a surgical procedure in which a part of gut is taken out and connected on the anterior abdominal wall. An anastomosis is the joining together of the two intestinal ends that remain after a diseased section has been removed. The closure of the stoma though thought to be minor surgical procedure, yet it may be associated with appreciable morbidity. When the reversal of stoma is done in less than 8 weeks following primary surgery then it is considered to be early closure. Early closure of the temporary stoma might reduce both stoma – related complications and patient ailment. Wound complications are common but there are many associated morbidities due to delay in closure. So the aim of this study is to find the complications associated with early closure of temporary stoma. Objective: To evaluate the outcome of early closure of temporary stoma. Material and Methods: This descriptive case series study of 350 patients of both gender aged between 13 – 70 years was conducted in surgical ward of mayo hospital, Lahore in one year duration from 01-01-2014 to 31-12-2014. The non-probability purposive sampling technique was used in this study. Written consent was obtained from the patients. Only the most senior consultants with 5 years’ experience after post-graduation were the part of the team. Following admission they were advised distal loopogram to rule out any distal obstruction, leakage or any other pathology. Closure was performed and the evaluation of the patient and relevant investigations pertaining to diagnose complications like anastomotic leakage and wound complications was done. This was recorded daily for 5 days post-operatively in ward and then a follow up weekly for 1 month was performed. Analysis of data was done statistically using version 13.0. Mean ± SD were calculated for age. Frequency and percentages were calculated for gender, anastomotic leakage and wound complications. Post-stratification chi-square test was applied keeping a P-value ≤ 0.05 as significant. Results: In our study mean age of the patients was 42.73 ± 13.68 years, 60% patients were males whereas 40% patients were females. The study results showed that anastomotic leakage was found in 29 (8.3%) patients and wound complication was found in 20.57% patients. Statistically insignificant difference was found between the wound complication and gender of the patients i.e. p-value = 0.82. Conclusion: According to our study results the out-come of early closure of temporary stoma is a feasible and effective procedure with fewer complications.
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