Prospective analysis of stoma-related complications

Background Stoma‐related complication rates vary between 10% and 70%, possibly because of varying lengths of follow‐up. It is thought that most of the complications improve with time. Furthermore, little is known about the commonly neglected but potentially quite distressing complications such as leakage, soiling and night‐time emptying. The aim of this audit was to examine prospectively whether there was any difference in the complication rates at different time‐points during the postoperative follow up period. Method A prospective study on 408 consecutive patients with either colostomy or ileostomy was conducted over a period of at least 2 years. Both emergency and elective procedures were included. Stoma related complications were analysed at 10 days, 3 months, 6 months, 1 year and 2 years postoperatively. Results Both elective and emergency stomas had similar complication rates. The percentage of patients who had stenosis (1–2%), retraction (8–22%), prolapse (1–3%) or odour (6–9%) did not significantly change with time. The complication rates for skin excoriation, leakage, soiling or night‐time emptying were higher amongst the ileostomy patients, and these rates did not improve with time. The proportion of patients who had parastomal hernias increased with time (from 0 to 40% in the colostomy and 0 to 22% in the ileostomy group). Daytime leakage, night‐time leakage, soiling and night‐time emptying were more problematic in the ileostomy group. Conclusions The proportion of patients who had postoperative stoma‐related complications did not improve with time, but the rate of parastomal hernias in both groups and night‐time emptying in the ileostomy group was worse with time. Ileostomy patients had a higher incidence of skin excoriation, leakage, soiling, and night‐time emptying, and they should receive additional support.