Mortality and complications after stoma closure.
OBJECTIVE
This study was undertaken to evaluate factors contributing to hospital mortality and complications of stoma closure.


METHODS
Retrospective cohort study.


METHODS
Department of Surgery of a 2500-bed university hospital.


METHODS
Consecutive eligible patients who underwent stoma closure were selected from a local registry containing 30 219 patients. The medical records of 587 adult patients were reviewed according to a predefined extraction form. Patients with additional, unrelated surgical interventions or younger than 18 years were excluded. Follow-up was complete for all included patients.


METHODS
The primary outcome variable was 30-day mortality; the secondary outcome variable was presence of surgery-related complications within 30 days.


RESULTS
We analyzed 533 patients with stoma closure between 1993 and 2001. The overall stoma closure-related mortality rate was 3% (15 patients); the overall stoma closure-related surgical complications rate was 20% (107 patients). Wound infections (9%) and anastomotic leakage (5%) were the most common surgical complications. Age was the only significant risk factor for survival (P = .02). Use of a soft silicone drain for intraperitoneal drainage (odds ratio, 1.62 [95% confidence interval, 1.07-2.45]; P = .03) was the only significant risk factor for complications. In patients with carcinoma as the primary disease (odds ratio, 0.61 [95% confidence interval, 0.40 to 0.93]; P = .02), we observed significantly fewer complications.


CONCLUSIONS
We found considerable mortality and complications after stoma closure. Apart from age, we could not identify any predictor for mortality in patients with stoma closure. Randomized studies are needed to determine whether certain types of drains influence outcome.
Pokorny
Herwig
H
Department of Surgery, University Hospital of Vienna, 21-A Wāhringer Gürtel 18-20, 1090 Vienna, Austria. herwig.pokorny@meduniwien.ac.at
Herkner
Harald
H
Jakesz
Raimund
R
Herbst
Friedrich
F
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D054047:Surgical Stomas