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Early versus conventional stoma closure following bowel surgery: A randomized controlled trial

BACKGROUND/AIM: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). PATIENTS AND METHODS: This study was designed as a...

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Autores principales: Nelson, Thirugnanasambandam, Pranavi, Amuda R., Sureshkumar, Sathasivam, Sreenath, Gubbi S., Kate, Vikram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848326/
https://www.ncbi.nlm.nih.gov/pubmed/29451185
http://dx.doi.org/10.4103/sjg.SJG_445_17
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author Nelson, Thirugnanasambandam
Pranavi, Amuda R.
Sureshkumar, Sathasivam
Sreenath, Gubbi S.
Kate, Vikram
author_facet Nelson, Thirugnanasambandam
Pranavi, Amuda R.
Sureshkumar, Sathasivam
Sreenath, Gubbi S.
Kate, Vikram
author_sort Nelson, Thirugnanasambandam
collection PubMed
description BACKGROUND/AIM: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). PATIENTS AND METHODS: This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included. The rate of complications (medical and surgical) following early and conventional stoma closure was assessed. Health-related QoL and LoH were also measured. RESULTS: One hundred patients were included, with 50 cases in each group. Postoperative complications including laparostoma (6% vs. 2%;P = 0.307), wound infection (32% vs. 18%; P = 0.106), intra-abdominal collection (14% vs. 18%; P = 0.585), anastomotic leak (4%vs. 8%;P = 0.400), and medical complications were comparable (22% vs. 32%;P = 0.257). The length of hospital stay, overall mortality and morbidity (64% vs. 44%; P = 0.05) were similar across the two groups. There was a significant reduction in the cost towards stoma care (96% vs. 2%; P = 0.001) in the early stoma closure group. Patients in the early stoma closure group also had a significantly better QoL. CONCLUSION: Early stoma closure does not carry an increased risk of postoperative complications, reduces cost towards stoma care, and leads to better a QoL.
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spelling pubmed-58483262018-03-21 Early versus conventional stoma closure following bowel surgery: A randomized controlled trial Nelson, Thirugnanasambandam Pranavi, Amuda R. Sureshkumar, Sathasivam Sreenath, Gubbi S. Kate, Vikram Saudi J Gastroenterol Original Article BACKGROUND/AIM: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). PATIENTS AND METHODS: This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included. The rate of complications (medical and surgical) following early and conventional stoma closure was assessed. Health-related QoL and LoH were also measured. RESULTS: One hundred patients were included, with 50 cases in each group. Postoperative complications including laparostoma (6% vs. 2%;P = 0.307), wound infection (32% vs. 18%; P = 0.106), intra-abdominal collection (14% vs. 18%; P = 0.585), anastomotic leak (4%vs. 8%;P = 0.400), and medical complications were comparable (22% vs. 32%;P = 0.257). The length of hospital stay, overall mortality and morbidity (64% vs. 44%; P = 0.05) were similar across the two groups. There was a significant reduction in the cost towards stoma care (96% vs. 2%; P = 0.001) in the early stoma closure group. Patients in the early stoma closure group also had a significantly better QoL. CONCLUSION: Early stoma closure does not carry an increased risk of postoperative complications, reduces cost towards stoma care, and leads to better a QoL. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5848326/ /pubmed/29451185 http://dx.doi.org/10.4103/sjg.SJG_445_17 Text en Copyright: © 2018 Saudi Journal of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Nelson, Thirugnanasambandam
Pranavi, Amuda R.
Sureshkumar, Sathasivam
Sreenath, Gubbi S.
Kate, Vikram
Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title_full Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title_fullStr Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title_full_unstemmed Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title_short Early versus conventional stoma closure following bowel surgery: A randomized controlled trial
title_sort early versus conventional stoma closure following bowel surgery: a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848326/
https://www.ncbi.nlm.nih.gov/pubmed/29451185
http://dx.doi.org/10.4103/sjg.SJG_445_17
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