Stoma creation through the stoma site: A rapid, safe technique

Edward R. Stephenson, Obeid Ilahi, Walter A. Koltun

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Stoma creation often involves a separate laparotomy incision. Recently, laparoscopy was suggested to minimize the morbidity associated with conventional open stomal techniques. We describe and evaluate a technique of stoma creation done directly through the stoma site, avoiding both laparotomy and laparoscopy. METHODS: Charts of 36 patients who underwent attempted stoma creation using this closed technique were retrospectively reviewed. RESULTS: A total of 32 patients had stomas successfully created in this fashion (closed group); although four patients failed and required laparotomy (open group), there was an overall success rate of 89 percent. Blood loss (17 ± 5 vs. 350 ± 130 ml; P < .001), operative time (52 ± 8 vs. 169 ± 35 minutes; P < 0.001), and complications (3/32 vs. 4/4; P < 0.001) favored the closed group. No factor, including diagnosis, obesity, or previous abdominal surgery were identified that contraindicated use of the closed technique. CONCLUSIONS: Stomas can be safely made in a high proportion of patients without the need for laparotomy or laparoscopy. Failure of the closed technique identifies a group of patients who have a high associated operative time, blood loss, and morbidity when laparotomy is used for stoma creation and in whom laparoscopic procedures may improve results.

Original languageEnglish (US)
Pages (from-to)112-115
Number of pages4
JournalDiseases of the colon and rectum
Volume40
Issue number1
DOIs
StatePublished - Jan 1 1997

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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