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Factors Influencing Morbidity and Mortality of Elective Stoma Closure
Gaurav Shanker Pandey, Robin Kaushik, Simrandeep Singh, Rajeev Sharma, Ashok Attri
Department of Surgery, Government Medical College and Hospital, Sector 32 B, 
Chandigarh 160030, India

Corresponding Author
Dr Robin Kaushik


Background: Stoma are often created in the emergency. These patients usually undergo restoration of bowel continuity electively 10 to 12 weeks later.
Material and Methods: Patients undergoing elective stoma closure were followed up for 3 months post-operatively for any morbidity (or mortality). Various patient and surgeon variables were analyzed to define factors that could affect the outcome of bowel restoration. 
Results: Of the 80 patients included, 62 were male (77.5%) and 18 (22.5%) female with an average age of 37.8 years. The commonest indication of stoma creation was peritonitis (52.5%); all patients underwent restoration after an average duration of 161.1 days. 47 patients (58.8%) developed 62 morbidity events – commonly, wound infection (47.5%), anastomotic leak (15%) and early post-operative ileus (6.25%). There were 4 deaths (5%). Univariate analysis revealed significantly higher rate of anastomotic leakin patients with low BMI, low hemoglobin, low albumin, laparotomy for restoration, and American Society of Anesthesiology (ASA) grade III. -Post-operative obstruction was significantly associated with delay in closure, laparotomy, ASA grade III , and when consultants performed restoration. Mortality was significantly higher in patients with age above 55 years, low BMI, ASA grade III, low pre-operative hemoglobin and after anastomotic leak.
Conclusion: Restoration is not an innocuous procedure; significant morbidity and mortality is associated with it. Proper timing of closure as well as optimizing the patient help in reducing the morbidity and mortality of the operation.