Purpose: The purpose of this study was to examine the relationships of stoma complications and sleep disorders with health-related quality of life (HRQOL) in ostomates.

Methods: A self-administered questionnaire was sent to 182 ostomates whose stoma had been created for the treatment of colorectal cancer and who were attending social adaptation training programs in Osaka prefecture. Surveyed factors included their clinical characteristics, stoma complications, sleep disorders, and HRQOL. Factors associated with HRQOL were also examined using multiple regression analysis (forced entry method).

Results: There were 133 valid responders (valid response rate:73.1%), and their responses were included in the analysis of this study. Their median age was 68 years and 79 (59.4%) were women. Factors associated with significantly better HRQOL in the ostomates were “no peristomal skin troubles” in the physical summary score, as well as “no leakage from the ostomy bag during sleep” and “no sleep disorders” in the mental summary score.

Conclusion: These findings suggest that it is necessary not only to perform stoma care to avoid skin troubles and leakage from the ostomy bag during sleep, but also to pay attention to factors related to sleep disorders, so that ostomates can sleep well with peace of mind.

Purpose: The present study aimed to identify risk factors for early postoperative stoma complications (EPSCs) after emergent surgery, as well as to investigate current methods of gastrointestinal stoma formation and its management by surgeons at our hospital.

Methods: The subjects were patients who had a gastrointestinal stoma created during emergent surgery between July 2010 and June 2015. The EPSCs were retrospectively reviewed, and their risk factors were identified by multivariate analysis. A questionnaire survey of surgeons at our hospital was performed regarding their current methods of gastrointestinal stoma formation and its management.

Results: A total of 206 patients (mean age 71.8 years, 108 males) were reviewed. EPSCs occurred in 80 patients (38.8%), consisting of 59 (28.6%) cases of mucocutaneous separation of the stoma and 21 (10.2%) cases of stomal necrosis. Hypertension and operation by senior residents with less than 6 years of surgical experience were identified as independent risk factors for EPSCs. The questionnaire survey indicated that the methods of forming the abdominal wall tunnel and approaches for removing stitches after stoma formation varied among the surgeons.

Conclusions: To prevent EPSCs after emergent surgery at our hospital, it might be necessary to control hypertension and standardize both the methods of gastrointestinal stoma formation and the instructions given by surgeons to the senior residents.

Temporary stoma construction is often performed during sphincter-preserving surgery for rectal disease, such as low anterior resection. In such cases, a loop ileostomy or loop colostomy is selected. The indications, problems, and points to note of each were examined based on past reports.

There were significantly more high-output stoma, dehydration, renal failure, and peristomal skin problems before closure, as well as intestinal obstruction after closure, in patients with loop ileostomy. In cases at high risk of these complications, loop colostomy was considered to be an option instead of ileostomy. There were significantly more cases of stomal prolapse and parastomal hernia before closure, as well as incisional hernia after closure, in patients with loop colostomy. It is useful to minimize the size of the stomal tunnel of the abdominal wall, which can be the main surgical technique-related cause of these complications. In addition, loop ileostomy was considered to be an option instead of colostomy in cases at high risk of these complications. In conclusion, both loop ileostomy and loop colostomy have advantages and disadvantages, and it is important to use them appropriately so as to make the most of their respective advantages.