TIMING OF THE STOMA REVERSAL, WHAT IS THE SAFE PERIOD?: A RETROSPECTIVE OBSERVATIONAL STUDY
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i5.51172Keywords:
Intestinal obstruction, Surgical stoma, Stoma reversal, ComplicationsAbstract
Objective: The objective of the study is to determine the most suitable timing for the reversal of enteric stomas and to investigate the complications associated with the presence and reversal of stomas among different age groups and genders.
Methods: This was a retrospective study conducted in the Department of General Surgery of a tertiary care medical institute. The institutional ethical committee approved the study. We reviewed the digitally recorded data of patients who had undergone both the creation and reversal of stomas at our institution over various time intervals spanning from January 2017 to December 2022. Beyond the electronically stored clinical data encompassing patient demographics, stoma type, and complications encountered between stoma insertion and reversal, we conducted a thorough review of the database containing information on outpatient follow-ups for a month. The gender and age distribution, indications for surgery, type of stoma, and its correlation with age and gender were analyzed. Duration from surgery to stoma reversal and complications were also analyzed. Categorical data were presented as frequency and percentage, whereas quantitative data were summarized using the mean and standard deviation. Closure of the stoma after surgery was compared based on age and sex, employing an independent t-test.
Results: In this study 82 patients undergoing stoma surgery, 68.29% were male and 31.71% were female. The mean age of male and female patients was found to be 44.26 and 35.96 years, respectively. Males had a higher median duration for ileostomy and jejunostomy reversals at 14 and 17 weeks, respectively, whereas females showed longer durations for ileostomy at 15 weeks. Common indications for surgery included intestinal obstruction (32.9%) and peritonitis (20.7%). Post-stoma closure 50% of the patients experienced complications, with 24% occurring within 1 month of reversal. Major complications occurred in 41% of cases, including parastomal hernia and suspected anastomotic leaks. Minor complications were observed in 28 patients, representing 35% of all surgeries.
Conclusion: Stoma reversal between 8 and 12 weeks post-surgery is recommended for minimizing complications and avoiding psychological burden. While early closure may reduce hospital stay, it increases the risk of infections. Optimal timing for stoma closure is complex, requiring personalized, collaborative decision-making.
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