TECHNICAL ASPECTS AND COMPLICATIONS OF END-ILEOSTOMIES

During a period of 10 years (1980-1990) we constructed or reconstructe d 358 end-ileostomies: 224 were primary constructions, 96 were reconst ructed by laparotomy, and 38 were local reconstruction. Only 2 ileosto mies were primarily located on the left side. The mean length was 5 cm . We had 11.6% reoperations after primary stomy and 7.3% and 7.9% reop erations after reconstruction by laparotomy and local approach, respec tively. There were 12.9% and 8.7% reoperations after emergency and ele ctive primary operations, respectively. Closing the lateral gutter or fixation of ileum to the rectus fascia did not influence significantly the number of reoperations. Postoperative discolored stomy did not in dicate more dysfunction of the ileostomy. Stenosis of the ileostomy, p eristomal fistulas, and peristomal dermatitis were seen in 23 (10.3%), 21 (9.4%), and 18 (8%) of the patients after primary ileostomies, res pectively. Patients with Crohn's disease had significantly more of the se problems than patients with ulcerative colitis. Only a few patients had retraction of the ileostomy (2.7%), stomal prolapse (1.8%), or pa rastomal herniation (1.8%). Women had significantly more parastomal he rniation than men; otherwise there were no differences between the sex es.