Temporal Pattern and Frequency of Ileostomy-related Complications: A Prospective Observational Study

Vollständiger Abstract

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Introduction: Ileostomy is frequently performed to divert faecal flow and protect distal bowel anastomoses in both elective and emergency surgical settings. However, postoperative complications remain a significant cause of morbidity and may affect patient recovery. Aim: To evaluate the frequency and temporal pattern of complications following ileostomy during the first 12 weeks after surgery. Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from July 2024 to December 2025. A total of 50 adult patients undergoing elective or emergency ileostomy were enrolled. Demographic, clinical, and laboratory parameters were recorded. Patients were assessed during hospitalisation and followed-up at four, eight, and 12 weeks for the occurrence of stoma-related complications. Results: The study included 50 patients with a mean age of 45.44±18.31 years; 66% were females. Emergency procedures accounted for 80% (n=40) of surgeries, and a loop ileostomy was performed in 94% (n=47) of cases. The common indications were malignancy (n=24, 48%), bowel obstruction (n=14, 28%), and perforation (n=12, 24%). During hospitalisation, 45 (90%) patients remained free of complications. This proportion decreased to 36% (n=18) at four weeks, then improved to 68% (n=34) at eight weeks and 88% (n=44) at 12 weeks. Skin excoriation was the most common complication at four weeks (n=19, 38%), followed by stomal prolapse (n=5, 10%) and high-output stoma (n=4, 8%). Retraction, parastomal hernia, stenosis, and necrosis were infrequent late complications. Conclusion: Ileostomy-related complications follow a distinct temporal pattern, with the highest frequency occurring during the first month after surgery.