Association of Risk Factors for the Mortality and Morbidity of Stoma Closure

Abstract

Background: Anastomal leakage is a main surgical difficulty and requires stoma closure. Objective: To find associated risks for mortality and morbidity of stoma closure. Study Design: Retrospective cohort study Place and Duration of Study: Department of Surgery Ward 2, Jinnah Sindh Medical University/Jinnah Postgraduate Medical Centre Karachi from 1st July 2020 to 30th June 2021. Methodology: One hundred and twenty patients undergone rectal carcinoma surgeries were enrolled. The complications were graded by Clavien-Dindo classification system. The stoma closure was done by two different methods; the anterior wall technique or resection with anastomosis. Time duration of surgery, scoring by American Society of Anaesthesiologists was done and clinical and demographic information documented. Results: There were 62.5% males while 37.5% females and mean age was 65.5±8.5 years range between 31 to 72 years. Vascular blood supply affected leaking anastomaly. No significant effect of stoma type or closing technique was seen. However the time of stoma (p=0.044) and ASA score closure was a main risk for causing complications and increasing morbidity or mortality chances. Conclusion: Time of closure, American Society of Anaesthesiologists score as well as vascular supply are risk factors for morbidity or mortality in stoma closure. Keywords: Surgical stoma closure, Risk factors, Morbidity, Mortality