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A close adherence to a stoma-therapeutic pathway improves immediate stoma-related outcomes and reduces the length of hospital stay

  • Clinical Study Protocol
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

New stoma creation is related to a wide range of implications and stoma-related complications could occur frequently. The aim was to assess the impact of a close stoma-therapeutic-care pathway (STCP) in terms of length of stay, autonomy in the management of the pouch, readmission rate, and stoma-related complications.

Methods

Patients undergoing surgery for colorectal disease and first stoma creation from January 2017 to December 2020 were analyzed. All patients enrolled had joined the Enhanced Recovery after Surgery (ERAS) protocol.

Results

Among 143 enrolled, 56 (40%) did not completely follow the STCP (group A), whereas 87 (60%) demonstrated strict compliance (group B). The hospital stay lasted 8 days in group B and 11.5 in group A (p = 0.001). The first look at the stoma needed 1 day in group B and 3 days in group A (p < 0.001), emptying the pouch 2 days in group B and 5 days in group A (p < 0.001). Finally, the ability to change the pouch was 3 days in group B and 6 days in group A (p < 0.001). Nine (16.1%) stoma-related complications were counted in group A and 16 (18.4%) in group B, and 30-day readmission was 10.1% in group B and 11.5% in group A (p = 0.82 and p = 1, respectively, not significant).

Conclusions

The STCP has been shown to reduce the hospital stay and to have a protective role making the patient autonomous in the management of the stoma.

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Data availability

The dataset generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Chirurgia Generale E Oncologica, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Turin, Italy

    Michela Mineccia, Antonio Valenti, Federica Gonella, Marco Palisi, Paolo Massucco & Alessandro Ferrero

  2. Clinical Trial Unit, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Turin, Italy

    Andrea Ricotti

Authors
  1. Michela Mineccia
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  2. Antonio Valenti
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  3. Federica Gonella
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  4. Marco Palisi
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  5. Paolo Massucco
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  6. Andrea Ricotti
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  7. Alessandro Ferrero
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Contributions

Michela Mineccia and Antonio Valenti designed the study and wrote the manuscript. Federica Gonella with Marco Palisi and Paolo Massucco filled the dataset and wrote the manuscript. Andrea Ricotti did the statistical analysis. Alessandro Ferrero supervised and wrote the manuscript.

Corresponding author

Correspondence to Michela Mineccia.

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The authors declare no competing interests.

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Mineccia, M., Valenti, A., Gonella, F. et al. A close adherence to a stoma-therapeutic pathway improves immediate stoma-related outcomes and reduces the length of hospital stay. Int J Colorectal Dis 37, 1719–1725 (2022). https://doi.org/10.1007/s00384-022-04200-z

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  • DOI: https://doi.org/10.1007/s00384-022-04200-z

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