Loop colostomy and loop ileostomy complications

Published Date: 19th July 2016

Publication Authors: Chadwick M

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Aim

The formation of a loop stoma is common practice in emergency and elective surgery, but has a profound effect on patient well-being, particularly if complications arise. In our District General Hospital we investigated and compared morbidity outcomes for patients who had loop stomas formed over a 1-year period.

Methods

A retrospective study of all patients who had a stoma formed during 2011 was performed. Data was collected using electronic patient records, and cross-referenced with our operation database held by our stoma nurses.

Results

During the study period, 122 stomas were formed. 80 (66%) were loop stomas, of which 33 (41%) were loop ileostomies (LI) and 44 (55%) were transverse loop colostomies (TLC). Three sigmoid loop colostomies (4%) were excluded from our analysis. Of the loop stomas formed, 26 TLC (59%) and 23 LI (70%) were fashioned electively, with the remainder being performed as an emergency (chi-squared 7.62, P < 0.05) 0.18 (41%) TLC and 13 (39%) LI were associated with a complication prior to reversal. Of these, 8 (18%) TLC and 3 (9%) LI were fashioned as an emergency. For all loop stomas, 63% were reversed (90% ileostomies, 48% colostomies). Of these, 37% experienced a post-operative complication, with 50% of LC and 24% of LI experiencing a post-operative complication (chi-squared 4.1, P < 0.025). 

Conclusion

Compared with loop ileostomies, a higher rate of complications is observed with both the formation, and reversal, of transverse loop colostomies.

Grainger, J; McHague, C; Chadwick, M; Rajaganeshan, R. (2014).  A comparison of transverse loop colostomy and loop ileostomy complications . Colorectal Disease. 16 (Supplement S2), 94.

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