Stoma Colostomy, Stoma Ileostomy
Conditions
Keywords
stoma, incisional hernia, midline incision
Brief summary
* Ileostomy or colostomy is a common surgical procedure used for diverting the lower gastrointestinal content away from distal pathology or anastomotic insufficiency. Once the distal problem has been fixed, the plan is to reverse the stoma. However, the reversal of a stoma is associated with complications, including anastomotic leaks, wound infection, and incisional hernias which can reach up to 33-50%. * The ideal site for a stoma on the abdominal wall depends on several factors, including the patient's anatomy, the type of stoma (colostomy or ileostomy), operative findings, and the patient's preferences. Stomas have traditionally been fashioned through the rectus muscle, away from the midline of the abdomen, and below the umbilicus. * Management of a stoma placed at the center of a long midline laparotomy wound is challenging with the risk of faecal contamination of midline incision. However in many scenarios, the surgeon is left without options rather than to exteriorize the bowel loop through the midline. Moreover, advantages of midline stoma may include: 1. Easy to create and save operative time. 2. Minimize destruction of the anterior abdominal wall (less tissue injury). 3. Eliminate the long-term risk of incisional hernia at the site of previous stoma. Only, few reports assess the outcomes of midline ostomy as a temporary stoma
Detailed description
This is a prospective cohort study
Interventions
PROCEDUREMidline stoma
stoma (ileostomy/colostomy) through midline incision
Sponsors
Assiut University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who will undergo temporary stoma (ileostomy/colostomy) through midline incision.
Exclusion criteria
* Patients with jejunostomy. * Patients with severe sepsis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Conversion rate | During surgery | Need for stoma revision (failure of midline stoma) and creation of conventional trans-rectus stoma. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of peristomal skin complications | 1 month after surgery | Number and percentage of patients with peristomal skin complications around stoma including erythema, erosion, ulceration and tissue overgrowth (hypergranulation) |
| Incidence of Incisional hernia after stoma reversal | 1 year after surgery | Number and percentage of patients developing incisional hernia at the previous stoma site (after stoma reversal) confirmed clinically or radiologically (ultrasound or CT) |
Countries
Egypt
Contacts
CONTACTMohamad Raafat, MD
CONTACTFaculty of Medicine-Assiut University
Outcome results
None listed