Pattern of Lower Intestinal Ostomies in a Low-Income Country: Case of Southeast of Niger Republic.

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Pattern of Lower Intestinal Ostomies in a Low-Income Country: Case of Southeast of Niger Republic.


JournalWorld journal of surgery
Publication date – Jun – 2018
Authors – Adamou, H; Habou, O; Amadou Magagi, I; Adakal, O; Magagi, A; Halidou, M; Sani, R
Keywordscolostomy, ileostomy, intestinal, retrospective
Open access – No
SpecialityGeneral surgery
World region Western Africa
Country: Niger
Language – English
Submitted to the One Surgery Index on July 21, 2018 at 12:00 am
Abstract:

Background
Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country.

Methods
This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study.

Results
During the study period, 2437 patients underwent digestive surgery, including 328 gastrointestinal stomas (13.5%). Patients classified ASA3 were 60.7% (n = 199). The median age was 12 years (IQ: 7–25). Children represent 64% (n = 210) of patients with ostomy. The sex ratio was 2.60. The stoma was performed in emergency in 96.3% (n = 316) of cases. Acute peritonitis was the main indication of the stoma in 70.73% (n = 232). The ileostomies accounted for 75.61% (n = 248). Ostomy was intended as temporary in 97.3% of cases (n = 319). Complications were observed in 188 patients (57.3%). Mortality was 14.02% (n = 46). The indigent status (OR: 4.15 [2.20–7.83], P = 000), ASA score 4 (OR: 2.53 [1.54–4.15], P = 0.0003), Altemeier class IV (OR: 4.03 [2.10–7.73], P = 0.0000) and ileostomy (OR: 2.7853 [1.47–5.29], P = 0.0018) were statistically associated with the occurrence of major complications. The mean time for stoma closure was 59.3 ± 14.5 days.

Conclusion
Acute peritonitis was the main indication of digestive ostomy. The occurrence of major complications was associated with bad socioeconomic status, ASA4 score, Altemeier class IV and ileostomy.

OSI Number – 10191
PMID – 29143090

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