“PROSPECTIVE RANDOMISED CONTROLLED TRIAL COMPARING EARLY POSTOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING LOOP COLOSTOMY WITH AND WITHOUT A STOMA ROD” Authors: Joshua Franklyn, Rohin Mittal, Mark Ranjan J., Benjamin Perakath, Department: Surgery unit 2, CMC Vellore. Background: Loop colostomy is a commonly performed operation which involves exteriorizing the colon with the intention of providing faecal diversion. The common complications associated with the operation are retraction, muco-cutaneous separation, stoma related necrosis, bleeding, congestion to name a few. The loop of colon has traditionally been anchored on the abdominal wall by a rod or bridge placed under the bowel across the trephine. This is believed to prevent stomal retraction and provide better diversion by separating the proximal and distal loops. On the other hand, the rod can cause congestion, oedema and vascular compromise. We wished to test the hypothesis that the rod is unnecessary when a stoma is created. This is the first randomised controlled trial that has questioned the use of a rod while doing a loop colostomy. Outcomes assessed: Primary Outcome: To compare the retraction rates of stomas created by both the operative techniques. Secondary Outcomes: 1. Bleeding from the stoma 2. Mucocutaneous separation 3. Stomal or parastomal abscesses 4. Stomal necrosis 5. Stomal oedema 6. Skin necrosis Methods: Prospective randomized controlled trial. They were randomly allotted into one of two arms, rod or no rod. Allocation concealment was by an opaque envelope which was opened by the operating surgeon after the colon was exteriorised. One hundred and one patients were randomised. There were 51 in rod and 50 in no rod arm. Results: One hundred and one patients were randomised into the study, 51 in the ‘rod arm’ and 50 in the ‘no rod arm’. Five patients were lost to follow up. Their baseline demographics and categorical variables were similar Early post-operative stomal necrosis, oedema and congestion were statistically and clinically significantly increased in the arm randomised to the rod. In 25% of patients the
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