INTESTINAL STOMA: CAUSES OF FORMATION AND ITS COMPLICATIONS

Abstract. Aim. The aim of our work was to analyze the causes of intestinal fistula formation in injuries and diseases of the abdominal cavity of different genesis and to identify the causes of complications in them. Materials and methods. The results of treatment of 88 patients who were treated at the Military Medical Clinical Center of the Central Region and the Military Medical Clinical Center of the Northern Region, who underwent surgery with formation of intestinal fistula for the period from 2015 to 2022, were studied. The reasons for surgery in 17 cases were combat trauma to the abdomen, in 53 ca-ses – intestinal disease of malignant origin, in 15 – diverticular disease, others: stab wound to the abdomen – in 1, pelviorectal paraproctitis – in 1, mesenteric thrombosis – in 1. Results and discussion. In the postoperative period 22 patients had complications after stoma formation. These complications were divided into complications from the stoma and intestine of the stoma, as well as the skin around the stoma. Some patients had 2-3 complications, so the total number of complications exceeded the total number of patients with complications. Among the early complications were observed: parastomal dermatitis (17) with ulceration (8), parastomal infiltrate (3), parastomal abscess (1), retraction of the stoma (3), stoma deviation from skin and its failure (1), necrosis of the stoma (1), bleeding (1), failure of the gut stump (1), abdominal abscess (1). Among the late complications we noted: prolapse of the stoma (3), ligature fistulas (7), stricture of the stoma (1), parastomal hernias (2), hypergranulation (6). The frequency of these complications, in our opinion, depends on the correct formation of the stoma with proper surgical techniques, taking into account the anatomical features of the structure of the anterior abdominal wall, the constitutional characteristics of the patient, the degree of infection of parastomal tissues. Conclusions. The most common early complications after stoma formation are purulent-inflammatory, which occurred in 25.0 % of patients operated on urgently. Among late complications, complications such as ligature fistulas, prolapse and paracolostomy hernias were common – up to 7.95 %, which required surgical correction.