Factors affecting the morbidity and mortality of diverting stoma closure: Retrospective cohort analysis of twelve year period
Introduction Protective stoma is often performed in rectal surgery for reducing the consequences of possible anastomotic failure. Closing of stoma follows in most cases after a few months. The aim of our study was to evaluate morbidity and mortality after protecting stoma closure and to identify risk factors for complications of this procedure.
Materials and methods We have performed a retrospective cohort analysis of data of 260 patients with protective stoma closure from 2003 to 2015 at our department. Age, stoma type, patient’s ASA status, surgical technique and time to stoma closure were investigated as factors which could influence the complication rate.
Results 218 patients were eligible for investigation. Postoperative complications developed in 54 patients (24.8%). Most common complications were postoperative ileus (10%) and wound infection (5%). 16 patients require reoperation. Four patients died (1.8%). There was no effect on complication rate regarding type of stoma, closing technique, patient’s ASA status, and patient age. The only factor which influenced the complication rate was the time to stoma closure. We found that patients which had the stoma closed prior to 8 months after primary surgery had lower overall complication rate (p<0. 05).
Conclusions Protective stoma closure is not a simple operation and should not be taken lightly because it is associated with significant morbidity and mortality. According to our data, the only factor that contributed to a lower complication rate was time to stoma closure.