Surgical management of ostomy complications: a MISSTO–WSES mapping review

World Journal of Emergency Surgery

Review

Francesco Pata¹  Francesco Ferrara²  Gianluca Rizzo³  Yoram Kluger⁴  Ernest Moore⁵  Andrea Bondurri⁶  Piergiorgio Danelli⁷  Massimo Sartelli⁸  Luca Ansaloni⁹  Dario Parini^1,10  Marco Veltri^1,11  Fausto Catena^1,12  Federico Coccolini^1,13  Cristiana Forni^1,14  Walt L. Biffl^1,15 

[1] Department of Pharmacy, Health and Nutricional Sciences, University of Calabria, Cosenza, Italy;Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy;Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy;Digestive and Colorectal Unit, Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Università Cattolica del Sacro Cuore, Roma, Italy;Division of General Surgery, Rambam Health Care Campus, Haifa, Israel;E. Moore Shock and Trauma Centre, Denver, CO, USA;General Surgery Department, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milano, Italy;General Surgery Department, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milano, Italy;Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milano, Italy;General Surgery Department, Macerata Hospital, Macerata, Italy;General Surgery Department, Pavia University Hospital, Pavia, Italy;General Surgery Department, Santa Maria della Misericordia Hospital, Rovigo, Italy;General Surgery Unit, San Jacopo Hospital, Pistoia, Italy;General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy;General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy;Nursing and allied profession research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA;

关键词: Stoma complication;    Surgical management;    Review;    Stoma necrosis;    Mucocutaneous separation;    Stoma retraction;    Stoma prolapse;    Parastomal hernia;    Stoma stenosis;    Stoma bleeding;   

DOI  :  10.1186/s13017-023-00516-5

 received in 2023-05-19, accepted in 2023-09-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe creation of an ileostomy or colostomy is a common surgical event, both in elective and in emergency context. The main aim of stoma creation is to prevent postoperative complications, such as the anastomotic leak. However, stoma-related complications can also occur and their morbidity is not negligible, with a rate from 20 to 70%. Most stomal complications are managed conservatively, but, when this approach is not resolutive, surgical treatment becomes necessary. The aim of this mapping review is to get a comprehensive overview on the incidence, the risk factors, and the management of the main early and late ostomy complications: stoma necrosis, mucocutaneous separation, stoma retraction, stoma prolapse, parastomal hernia, stoma stenosis, and stoma bleeding.Material and methodsA complete literature research in principal databases (PUBMED, EMBASE, SCOPUS and COCHRANE) was performed by Multidisciplinary Italian Study group for STOmas (MISSTO) for each topic, with no language restriction and limited to the years 2011–2021. An international expert panel, from MISSTO and World Society of Emergency Surgery (WSES), subsequently reviewed the different issues, endorsed the project, and approved the final manuscript.ConclusionStoma-related complications are common and require a step-up management, from conservative stoma care to surgical stoma revision. A study of literature evidence in clinical practice for stoma creation and an improved management of stoma-related complications could significantly increase the quality of life of patients with ostomy. Solid evidence from the literature about the correct management is lacking, and an international consensus is needed to draw up new guidelines on this subject.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023. corrected publication 2023

【 图 表 】

Fig. 6

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