Parmar KL, Zammit M, Smith A, Kenyon D, Lees NP, Greater Manchester and Cheshire Colorectal Cancer Network., et al.
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain.... Date of publication 2011 Aug 1;volume 13(8):935-8.
1. Colorectal Dis. 2011 Aug;13(8):935-8. doi: 10.1111/j.1463-1318.2010.02325.x. Epub
2010 May 17.
A prospective audit of early stoma complications in colorectal cancer treatment
throughout the Greater Manchester and Cheshire colorectal cancer network.
Parmar KL(1), Zammit M, Smith A, Kenyon D, Lees NP; Greater Manchester and
Cheshire Colorectal Cancer Network.
Author information:
(1)Salford Royal NHS Foundation Trust, Colorectal Surgery, Salford, Greater
Manchester, UK.
AIM: The study aimed to identify the incidence of early stoma problems after
surgery for colorectal cancer to identify predisposing factors and to assess the
effect on discharge from hospital and the greater need for community stoma care.
METHOD: A prospective study of 192 patients was carried out over a six-month
period in the 13 units of the Greater Manchester and Cheshire Cancer Network.
Stoma problems were categorized into fistula, leakage, pancaking, necrosis,
retraction, separation, stenosis, skin problems, parastomal hernia, suboptimal
stoma site and need for resiting or refashioning. Differences in incidence
between units (anonymized) were analysed, and the effect of stoma complications
on length of hospital stay and the need for additional community stoma care was
determined.
RESULTS: One hundred and ninety-two patients with stomas were included, of which
52 (27.1%) were identified as being problematic (range 0-66.7% between units).
Significant risk factors included stoma type (colostomy) (P < 0.05), short stoma
length (P = 0.006), higher BMI (P = 0.043), emergency surgery (P = 0.002) and
lack of preoperative site marking (P < 0.001). Problematic stomas were associated
with longer hospital stay (P < 0.001) and increased community care (P < 0.001).
CONCLUSION: Stoma type, stoma length, body mass index, emergency surgery and lack
of preoperative marking were significant risk factors. Overall complication rates
compare favourably with other studies.
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology
of Great Britain and Ireland.
DOI: 10.1111/j.1463-1318.2010.02325.x
PMID: 20478001 [Indexed for MEDLINE]
