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abstract:
Original paper
Preliminary results of Polish national multicenter study on colostomy reversal – LICO (Liquidation of Colostomy) study
Michał Kisielewski
1, 2
,
Karolina Jeleńska-Bieńkowska
8
,
Tomasz Sachańbiński
14, 15
,
Wojciech M. Wysocki
1, 2, 18
1.
Chair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
2.
Department of Oncological Surgery, 5th Military Clinical Hospital, Krakow, Poland
3.
Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
4.
Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Krakow, Poland
5.
Chair of Surgical Oncology, Ludwik Rydygier’s Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
6.
Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
7.
Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland
8.
Department of General and Oncological Surgery, Military Institute of Medicine, National Research Institute, Warsaw, Poland
9.
Division of Oncological Propedeutics, Medical University of Gdansk and Surgical Oncology, Oncological Center, Gdynia, Poland
10.
Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland
11.
Collegium Medicum, Jan Kochanowki Universitz, Kielce, Poland
12.
Department of Surgical Oncology, J. Śniadecki Specialist Hospital, Nowy Sącz, Poland
13.
Oncological Surgery Clinic, MSWiA Hospital, Olsztyn, Poland
14.
Oncological Surgery Department with a Sub-department of Breast Diseases, Tadeusz Koszarowski Oncology Centre in Opole, Opole, Poland
15.
Institute of Medical Sciences, Faculty of Medicine, University of Opole, Opole, Poland
16.
Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo, Poland
17.
2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
18.
National Institute of Oncology Maria Skłodowska-Curie Memorial, Warsaw, Poland
Videosurgery Miniinv
Online publish date: 2024/04/10
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Introduction
Creation of colostomy is still a commonly performed procedure in emergency settings, when intestinal anastomosis cannot be performed safely. Reversing a stoma has been linked with high rates of morbidity and also mortality.
Aim
The primary goal of the study was to identify the risk of postoperative complications in patients undergoing colostomy liquidation. The secondary goal was to assess perioperative care parameters.
Material and methods
The LIquidation of COlostomy (LICO) study is an open multicenter prospective cohort study that began in October 2022 and will continue until December 2023. Data from 20 Polish surgical departments were collected. Overall 45 patients were reported over the initial 3 months; based on that group we performed a preliminary analysis.
Results
Mean operative time was 163 min. Patients were operated on by specialists in 93.3% of cases. Complications occurred in 15 (33.3%) patients. Wound infection was the most common complication (17.8%). In 3 (6.7%) cases anastomotic leakage was diagnosed, and in 2 of those cases reoperation was required. The overall mortality rate was 2.2%. The mean length of hospital stay was 10.1 days. Preoperative fasting was used in 53.3% of patients, and the mechanical bowel preparation rate was 75.6%. Only in 8.9% of cases was laparoscopic access used for stoma reversal, and only in 1 out of 45 cases was mesh used for incisional peristomal hernia prophylactics. The stoma site was closed by single sutures in 73.3%, and negative pressure assisted closure was performed in 6.7% of patients.
Conclusions
Colostomy liquidation is associated with significant morbidity and minor mortality in the Polish population. Standardized perioperative care should be established for stoma reversal surgery.
keywords:
postoperative complications, colostomy, colostomy reversal, liquidation of colostomy
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