Intestinal stoma in patients with spinal cord injury: a retrospective study of 23 patients.
OBJECTIVE
Among spinal cord injury patients, digestive disorders are frequent, chronic, and progressive. Constipation and fecal incontinence, the most common disorders, can severely affect the quality of life of patients with spinal cord injury (SCI).


METHODS
For this retrospective study, we reviewed the medical records of spinal cord injury patients with an intestinal stoma formation and developed a questionnaire to assess patient quality of life. Between January 1, 1996, and December 31, 2005, 10 SCI patients had a stoma formation for constipation, 10 for wound management, and 3 for other causes. Most of these stomas were performed by laparoscopy, with no postoperative mortality.


RESULTS
Postoperative morbidity was 26% at the general level, with a rate of 4% at the local level; morbidity reached 56% at longer follow-up. The average period of bowel dysfunction was 7.2 years. The average time per week spent on bowel management (bowel care and defecation time) was 6 h prior to stoma formation, but decreased to 1.5 h afterwards. Half of the questionnaire respondents reported an improved quality of life.


CONCLUSIONS
A left colostomy is an effective and safe alternative for anorectal disorders among SCI patients. For a large percentage of patients, it ensures an improved quality of life.
Munck
J
J
Department of Digestive, Laparoscopic and Thoracic Surgery, C.H.U. Brugmann, U.L.B., Brussels, Belgium.
Simoens
Ch
Ch
Thill
V
V
Smets
D
D
Debergh
N
N
Fievet
F
F
Mendes da Costa
P
P
D000328:Adult; D000368:Aged; D003125:Colostomy; D003248:Constipation / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D003668:Pressure Ulcer / Q000150:complications / Q000601:surgery; D011788:Quality of Life; D012003:Rectal Fistula / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult