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Emergency stomas; should non-colorectal surgeons be doing it?
Adnan Qureshi1, Joanne Cunningham2, Anil Hemandas3
1Northampton General Hospital NHS trust, UK.
Gastroenterology and Hepatology From Bed to Bench
|November 15, 2018
Summary
Emergency stoma surgery has higher complication rates, especially when not performed by colorectal specialists. These stomas require careful management to avoid severe patient outcomes.
Area of Science:
- Colorectal Surgery
- Surgical Complications
- Stoma Care
Background:
- Emergency stomas have higher complication rates.
- Preoperative stoma site marking by therapists is crucial.
- Stoma complications significantly impact patient quality of life.
Purpose of the Study:
- Compare short-term general and stoma-specific complications in emergency versus elective stoma surgery.
- Evaluate complications based on surgeon specialization (colorectal vs. non-colorectal).
Main Methods:
- Retrospective analysis of non-urological stomas (Jan 2014-Jan 2017).
- Data included stoma type, indication, operation, length of stay, and Clavien-Dindo complications.
- Analysis of perioperative stoma complications in the emergency cohort.
Main Results:
- Higher grade 3/4 complications in the emergency cohort (60 patients) versus elective (135 patients).
- Increased complications observed when stomas were performed by non-colorectal specialists.
- Stoma-related issues (retraction, necrosis, prolapse) predominated in emergency cases by non-specialists.
Conclusions:
- Emergency stoma surgery is complex and not to be underestimated.
- Non-colorectal surgeons should seek specialist colorectal surgical input for bowel-related cases, especially involving stomas.
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