Advertisement

World Journal of Surgery

, Volume 43, Issue 3, pp 751–757 | Cite as

Complications After Ostomy Surgery: Emergencies and Obese Patients are at Risk—Data from the Berlin OStomy Study (BOSS)

  • Chris Braumann
  • Verena Müller
  • Moritz Knies
  • Birgit Aufmesser
  • Wolfgang Schwenk
  • Gerold KoplinEmail author
Original Scientific Report
  • 70 Downloads

Abstract

Background

Complications are common after ostomy surgery. Data from the Berlin OStomy Study were evaluated to determine risk factors for complications.

Patients and methods

Patients with a bowel ostomy were questioned using a questionnaire concerning patients’ characteristics and history as well as the ostomy and its complications. The questionnaire also contained a nine-fielded abdominal sketch to determine the exact ostomy location.

Results

Over 42 months, 2647 patients completed the questionnaire. Obese patients and patients after emergency surgery were more prone to ostomy-related complications. This result was independent of the kind of ostomy (small bowel ostomy or colostomy) and of the abdominal location. The overall ostomy complication rate was 55.6%.

Conclusion

Significantly more complications were recorded after emergency surgery and in obese patients than after elective surgery and in non-obese patients, respectively. There was no preferential abdominal location for avoiding general ostomy complications. The results emphasized the importance of preoperative ostomy site marking by qualified personnel such as ostomy nurses or surgeons to reduce complication rates by respecting individual abdominal configurations. With an increasing prevalence of obesity, ostomy surgery will become even more challenging in the future. A division of the abdominal wall into nine regions might be helpful and more precise for describing and examining ostomy-related complications in the future.

Notes

Acknowledgements

The company PubliCare® (Cologne, Germany) supported this study by contacting the patients and collecting the data. PubliCare® is responsible for home wound treatment and professional ostomy care.

Compliance with ethical standards

Conflict of interest

None of the authors declare a conflict of interest.

Informed consent

The Declaration of Helsinki was observed, and consent was obtained from all patients.

References

  1. 1.
    Sheetz KH, Waits SA, Krell RW et al (2014) Complication rates of ostomy surgery are high and vary significantly between hospitals. Dis Colon Rectum 57:632–637CrossRefGoogle Scholar
  2. 2.
    Braumann C, Muller V, Knies M, Aufmesser B, Schwenk W, Koplin G (2016) Quality of life and need for care in patients with an ostomy: a survey of 2647 patients of the Berlin OStomy-Study (BOSS). Langenbeck’s Arch Surg 401:1191–1201CrossRefGoogle Scholar
  3. 3.
    Iversen LH, Bulow S, Christensen IJ, Laurberg S, Harling H (2008) Danish Colorectal Cancer G. Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer. Br J Surg 95:1012–1019CrossRefGoogle Scholar
  4. 4.
    Maydick D (2016) A descriptive study assessing quality of life for adults with a permanent ostomy and the influence of preoperative stoma site marking. Ostomy Wound Manag 62:14–24Google Scholar
  5. 5.
    Salvadalena G, Hendren S, McKenna L et al (2015) WOCN society and ASCRS position statement on preoperative stoma site marking for patients undergoing colostomy or ileostomy surgery. J Wound Ostomy Cont Nurs 42:249–252CrossRefGoogle Scholar
  6. 6.
    Crooks S (1994) Foresight that leads to improved outcome: stoma care nurses’ role in siting stomas. Prof Nurse 10:89–92Google Scholar
  7. 7.
    Pengelly S, Reader J, Jones A, Roper K, Douie WJ, Lambert AW (2014) Methods for siting emergency stomas in the absence of a stoma therapist. Ann R Coll Surg Engl 96:216–218CrossRefGoogle Scholar
  8. 8.
    Londono-Schimmer EE, Leong AP, Phillips RK (1994) Life table analysis of stomal complications following colostomy. Dis Colon Rectum 37:916–920CrossRefGoogle Scholar
  9. 9.
    Leong AP, Londono-Schimmer EE, Phillips RK (1994) Life-table analysis of stomal complications following ileostomy. Br J Surg 81:727–729CrossRefGoogle Scholar
  10. 10.
    Sjodahl R, Anderberg B, Bolin T (1988) Parastomal hernia in relation to site of the abdominal stoma. Br J Surg 75:339–341CrossRefGoogle Scholar
  11. 11.
    Arumugam PJ, Bevan L, Macdonald L et al (2003) A prospective audit of stomas–analysis of risk factors and complications and their management. Colorectal Dis 5:49–52CrossRefGoogle Scholar
  12. 12.
    Kluger Y, Ben-Ishay O, Sartelli M et al (2013) World society of emergency surgery study group initiative on Timing of Acute Care Surgery classification (TACS). World J Emerg Surg 8:17CrossRefGoogle Scholar
  13. 13.
    Jacquet P, Sugarbaker PH (1996) Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res 82:359–374CrossRefGoogle Scholar
  14. 14.
    Macdonald A, Chung D, Fell S, Pickford I (2003) An assessment of surgeons’ abilities to site colostomies accurately. Surgeon 1:347–349CrossRefGoogle Scholar
  15. 15.
    Person B, Ifargan R, Lachter J, Duek SD, Kluger Y, Assalia A (2012) The impact of preoperative stoma site marking on the incidence of complications, quality of life, and patient’s independence. Dis Colon Rectum 55:783–787CrossRefGoogle Scholar
  16. 16.
    Landais A, Morel M, Goldstein J et al (2017) Evaluation of financial burden following complications after major surgery in France: potential return after perioperative goal-directed therapy. Anaesth Crit Care Pain Med 36:151–155CrossRefGoogle Scholar
  17. 17.
    Brunelli A, Drosos P, Dinesh P, Ismail H, Bassi V (2017) The severity of complications is associated with postoperative costs after lung resection. Ann Thorac Surg 103:1641–1646CrossRefGoogle Scholar
  18. 18.
    Berrington de Gonzalez A, Hartge P, Cerhan JR et al (2010) Body-mass index and mortality among 1.46 million white adults. N Engl J Med 363:2211–2219CrossRefGoogle Scholar
  19. 19.
    Livingston EH, Ko CY (2002) Use of the health and activities limitation index as a measure of quality of life in obesity. Obes Res 10:824–832CrossRefGoogle Scholar
  20. 20.
    Tjeertes EK, Hoeks SE, Beks SB, Valentijn TM, Hoofwijk AG, Stolker RJ (2015) Obesity–a risk factor for postoperative complications in general surgery? BMC Anesthesiol 15:112CrossRefGoogle Scholar
  21. 21.
    Dindo D, Muller MK, Weber M, Clavien PA (2003) Obesity in general elective surgery. Lancet 361:2032–2035CrossRefGoogle Scholar
  22. 22.
    Beck SJ (2011) Stoma issues in the obese patient. Clin Colon Rectal Surg 24:259–262CrossRefGoogle Scholar
  23. 23.
    Duchesne JC, Wang YZ, Weintraub SL, Boyle M, Hunt JP (2002) Stoma complications: a multivariate analysis. Am Surg 68:961–966 discussion 6 Google Scholar
  24. 24.
    De Raet J, Delvaux G, Haentjens P, Van Nieuwenhove Y (2008) Waist circumference is an independent risk factor for the development of parastomal hernia after permanent colostomy. Dis Colon Rectum 51:1806–1809CrossRefGoogle Scholar
  25. 25.
    Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL (2009) Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology 136(115–22):e1Google Scholar
  26. 26.
    Renehan AG, Soerjomataram I, Tyson M et al (2010) Incident cancer burden attributable to excess body mass index in 30 European countries. Int J Cancer 126:692–702CrossRefGoogle Scholar
  27. 27.
    Roveron G, De Toma G, Barbierato M (2016) Italian Society of Surgery and Association of Stoma Care Nurses Joint position statement on preoperative stoma siting. J Wound Ostomy Cont Nurs 43:165–169CrossRefGoogle Scholar
  28. 28.
    Rutledge M, Thompson MJ, Boyd-Carson W (2003) Effective stoma siting. Nurs Stand 18:43–44CrossRefGoogle Scholar
  29. 29.
    Liang S, Russek K, Franklin ME (2012) Jr. Damage control strategy for the management of perforated diverticulitis with generalized peritonitis: laparoscopic lavage and drainage vs. laparoscopic Hartmann’s procedure. Surg Endosc 26:2835–2842CrossRefGoogle Scholar
  30. 30.
    Vermeulen J, Lange JF (2010) Treatment of perforated diverticulitis with generalized peritonitis: past, present, and future. World J Surg 34:587–593CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Chris Braumann
    • 1
  • Verena Müller
    • 2
  • Moritz Knies
    • 1
  • Birgit Aufmesser
    • 2
  • Wolfgang Schwenk
    • 3
  • Gerold Koplin
    • 2
    • 4
    Email author
  1. 1.Department of General and Visceral Surgery, St. Josef-HospitalRuhr University of BochumBochumGermany
  2. 2.Department of General, Visceral, Vascular and Thoracic SurgeryCharité - University Medicine BerlinBerlinGermany
  3. 3.Department of General and Visceral SurgeryStädtisches KlinikumSolingenGermany
  4. 4.Klinik für Minimal Invasive Chirurgie (MIC)BerlinGermany

Personalised recommendations