Opportunities for Prevention of Complications in Intestinal Stoma Surgery

Aim: to reduce the number of paracolostomy complications and improve the quality stoma patients’ life by justifying the use of a comprehensive approach to the end colostomy, including preoperative marking, taking into account the variants of the structure of the muscular-aponeurotic frame of the ant...

Full description

Saved in:
Bibliographic Details
Main Authors: V. S. Groshilin, V. D. Kuznetsov, D. V. Kuznetsov, A. A. Pogosyan
Format: Article
Language:Russian
Published: Gastro LLC 2025-02-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
Subjects:
Online Access:https://www.gastro-j.ru/jour/article/view/1169
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823860026208419840
author V. S. Groshilin
V. D. Kuznetsov
D. V. Kuznetsov
A. A. Pogosyan
author_facet V. S. Groshilin
V. D. Kuznetsov
D. V. Kuznetsov
A. A. Pogosyan
author_sort V. S. Groshilin
collection DOAJ
description Aim: to reduce the number of paracolostomy complications and improve the quality stoma patients’ life by justifying the use of a comprehensive approach to the end colostomy, including preoperative marking, taking into account the variants of the structure of the muscular-aponeurotic frame of the anterior abdominal wall, as well as the individual features of vascularity and topography of the intestine section undergoing ostomy surgery.Materials and methods. To confirm the effectiveness of the proposed algorithm, an analysis of 52 clinical observations in patients who underwent surgeries with the formation of an end colostomy was carried out, which made up two clinical groups. In group 1 (n = 25) the developed therapeutic and diagnostic algorithm was applied, which included a rational choice of the colostomy localization site, taking into account individual features of the anterior abdominal wall structure, the quality of vascularity of the ostomy intestine, the terminal portion of its mesentery, the length and topography of the end section. Group 2 of patients (n = 27) underwent ostomy creation surgery using traditional techniques, without considering individual features.Results. The obtained results indicate the possibility of reducing the number of early (group 1 — 16 %, group 2 — 40.7 %; p < 0.05) and late (group 1 — 8 %, group 2 — 29.6 %; p < 0.05) paracolostomy complications, decreasing the number of repeated surgical interventions (three cases of re-creation of the stoma in the early postoperative period in group 2 and no indication for repeated interventions in group 1) and improving the quality of life in stoma patient through the application of the developed personalized algorithm. The assessment of the psychological (group 1 — 33.24, group 2 — 53.41) and physical (group 1 — 32.46, group 2 — 54.78) components of health based on the results of the SF-36 survey confirmed the advantages of the proposed tactics and therapeutic and diagnostic algorithm in group 1. The average number of hospital-stay days was also less in patients of clinical group 1 — 12.1 ± 3.4 days vs. 16 ± 4.7 in group 2.Conclusions. The use of patient-centered complex approach to determining the place and method of formation of an end colostomy, which includes taking into account the individual structure of the muscular-aponeurotic frame of the anterior abdominal wall, and the peculiarities of vascularity and topography of the intestine section undergoing ostomy surgery, is accompanied by a low number of early and late paracolostomy complications.
format Article
id doaj-art-05c56d69b4994c2998997f677bea5fba
institution Kabale University
issn 1382-4376
2658-6673
language Russian
publishDate 2025-02-01
publisher Gastro LLC
record_format Article
series Российский журнал гастроэнтерологии, гепатологии, колопроктологии
spelling doaj-art-05c56d69b4994c2998997f677bea5fba2025-02-10T16:14:40ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732025-02-01346677510.22416/1382-4376-2024-34-6-67-751144Opportunities for Prevention of Complications in Intestinal Stoma SurgeryV. S. Groshilin0V. D. Kuznetsov1D. V. Kuznetsov2A. A. Pogosyan3Rostov State Medical UniversityRostov State Medical UniversityCentral District Hospital in the Neklinovsky districtCity Clinical Hospital No. 6Aim: to reduce the number of paracolostomy complications and improve the quality stoma patients’ life by justifying the use of a comprehensive approach to the end colostomy, including preoperative marking, taking into account the variants of the structure of the muscular-aponeurotic frame of the anterior abdominal wall, as well as the individual features of vascularity and topography of the intestine section undergoing ostomy surgery.Materials and methods. To confirm the effectiveness of the proposed algorithm, an analysis of 52 clinical observations in patients who underwent surgeries with the formation of an end colostomy was carried out, which made up two clinical groups. In group 1 (n = 25) the developed therapeutic and diagnostic algorithm was applied, which included a rational choice of the colostomy localization site, taking into account individual features of the anterior abdominal wall structure, the quality of vascularity of the ostomy intestine, the terminal portion of its mesentery, the length and topography of the end section. Group 2 of patients (n = 27) underwent ostomy creation surgery using traditional techniques, without considering individual features.Results. The obtained results indicate the possibility of reducing the number of early (group 1 — 16 %, group 2 — 40.7 %; p < 0.05) and late (group 1 — 8 %, group 2 — 29.6 %; p < 0.05) paracolostomy complications, decreasing the number of repeated surgical interventions (three cases of re-creation of the stoma in the early postoperative period in group 2 and no indication for repeated interventions in group 1) and improving the quality of life in stoma patient through the application of the developed personalized algorithm. The assessment of the psychological (group 1 — 33.24, group 2 — 53.41) and physical (group 1 — 32.46, group 2 — 54.78) components of health based on the results of the SF-36 survey confirmed the advantages of the proposed tactics and therapeutic and diagnostic algorithm in group 1. The average number of hospital-stay days was also less in patients of clinical group 1 — 12.1 ± 3.4 days vs. 16 ± 4.7 in group 2.Conclusions. The use of patient-centered complex approach to determining the place and method of formation of an end colostomy, which includes taking into account the individual structure of the muscular-aponeurotic frame of the anterior abdominal wall, and the peculiarities of vascularity and topography of the intestine section undergoing ostomy surgery, is accompanied by a low number of early and late paracolostomy complications.https://www.gastro-j.ru/jour/article/view/1169end colostomyintestinal stoma complicationsparacolostomy herniaspreoperative markings on the anterior abdominal wall
spellingShingle V. S. Groshilin
V. D. Kuznetsov
D. V. Kuznetsov
A. A. Pogosyan
Opportunities for Prevention of Complications in Intestinal Stoma Surgery
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
end colostomy
intestinal stoma complications
paracolostomy hernias
preoperative markings on the anterior abdominal wall
title Opportunities for Prevention of Complications in Intestinal Stoma Surgery
title_full Opportunities for Prevention of Complications in Intestinal Stoma Surgery
title_fullStr Opportunities for Prevention of Complications in Intestinal Stoma Surgery
title_full_unstemmed Opportunities for Prevention of Complications in Intestinal Stoma Surgery
title_short Opportunities for Prevention of Complications in Intestinal Stoma Surgery
title_sort opportunities for prevention of complications in intestinal stoma surgery
topic end colostomy
intestinal stoma complications
paracolostomy hernias
preoperative markings on the anterior abdominal wall
url https://www.gastro-j.ru/jour/article/view/1169
work_keys_str_mv AT vsgroshilin opportunitiesforpreventionofcomplicationsinintestinalstomasurgery
AT vdkuznetsov opportunitiesforpreventionofcomplicationsinintestinalstomasurgery
AT dvkuznetsov opportunitiesforpreventionofcomplicationsinintestinalstomasurgery
AT aapogosyan opportunitiesforpreventionofcomplicationsinintestinalstomasurgery