A PROSPECTIVE OBSERVATIONAL ANALYTIC STUDY OF INDICATIONS, MANAGEMENT AND COMPLICATIONS OF DIFFERENT INTESTINAL STOMA

Background: Intestinal stoma formation is a commonly performed surgical procedure used for fecal diversion in a variety of emergency and elective gastrointestinal conditions. Although often lifesaving, stoma formation is associated with significant postoperative morbidity that may adversely affect patient outcomes and quality of life. Identification of factors associated with postoperative complications is essential for improving surgical outcomes and optimizing patient care.

Objectives: To evaluate the indications, management practices, complications, and outcomes of different intestinal stomas and to identify predictors of postoperative complications among patients undergoing intestinal stoma surgery.

Materials and Methods: This prospective observational analytic study was conducted in the Department of General Surgery at a tertiary care teaching hospital. A total of 101 consecutive patients undergoing newly constructed intestinal stoma surgery were included. Demographic, clinical, operative, and postoperative data were collected using a structured proforma. Postoperative complications, management modalities, duration of hospital stay, and final outcomes were assessed. Statistical analysis included Chi-square test, Student’s t-test, ANOVA, binary logistic regression, and receiver operating characteristic (ROC) curve analysis. A p-value <0.05 was considered statistically significant.

Results: The mean age of the study participants was 43.7 ± 15.6 years, and 72.3% were males. Enteric/ileal perforation was the most common indication for stoma formation (38.6%), followed by intestinal obstruction (17.8%) and colorectal malignancy (15.8%). Emergency surgery accounted for 80.2% of procedures, while loop ileostomy was the most commonly performed stoma (50.5%). Overall postoperative complications occurred in 62.4% of patients, with peristomal skin excoriation (33.7%), stomal edema (17.8%), and surgical site infection (15.8%) being the most frequent complications. Complications were significantly associated with ileostomy (p=0.002), emergency surgery (p=0.001), and presence of comorbidities (p=0.004). Binary logistic regression identified emergency surgery (AOR 3.42; 95% CI: 1.28–9.11), ileostomy (AOR 2.87; 95% CI: 1.16–7.08), and diabetes mellitus (AOR 2.49; 95% CI: 1.01–6.13) as independent predictors of postoperative complications. The mean hospital stay was 13.9 ± 5.8 days. Most patients (85.1%) improved and were discharged successfully.

Conclusion: Intestinal stoma surgery in the present setting was predominantly performed in emergency situations for enteric perforation and intestinal obstruction. Postoperative complications were common, particularly among patients undergoing ileostomy, emergency surgery, and those with diabetes mellitus. Early identification of high-risk patients, optimization of comorbid conditions, and improved stoma care services may reduce postoperative morbidity and enhance clinical outcomes.