TREATMENT OUTCOME OF STOMA REVERSAL AND ASSOCIATED FACTORS AMONG PATIENTS ADMITTED TO SURGICAL WARDS OF TWO PUBLIC HOSPITALS IN HARAR TOWN, EASTERN ETHIOPIA

Abstract

Background: Stoma reversal is associated with wide variation in reported morbidity and mortality. Its operative mortality rates are as high as 10% with morbidity rates of 30%-40% and anastomotic leakage rates of 15% have been reported. Moreover, surgical site infection is the most common complication, followed by intestinal obstruction, incisional hernia, and anastomotic leakage from the site of the ileostomy or colostomy repair. Although the complication of stoma reversal has negative consequences on the patient outcomes, factors affecting treatment outcome of stoma reversal are not widely investigated in Ethiopia, particularly in Eastern Ethiopia. Objective: To assess the treatment outcome of stoma reversal surgeries and associated factors among adult patients admitted to surgical ward of Hiwot Fana Comprehensive Specialized Hospital and Jugal General Hospital from November 1 to 31, 2023. Methods: A facility based cross-sectional study design (8-years retrospective analysis) was conducted in two public hospitals found in Harar town, Eastern Ethiopia from November 1 to 31, 2023 to retrieve 8-years records (September 1, 2015 to August 31, 2023). A total 102 medical records of patients who underwent stoma reversal were randomly selected and retrieved. Data were collected using structured checklists. The collected data entered into Epi Data version 3.1 and exported to SPSS version 26 for further analysis. A binary logistic regression was conducted to estimate the effect of each predictor variable on treatment outcome of stoma reversal. A multivariable analysis was done and reported using the AOR with 95% CI. Statistical significance was be declared significant at p-value<0.05. Results: The overall postoperative complication of stoma reversal was 34.3% [95%CI (26.1-43.5)]. The most common type of stoma reversal was colostomy operation (63.7%). In the final model of multivariable analysis predictors variables such as: Having a colostomy reversal operation[AOR:5.40;95%CI(1.09-26.21)], being in the advanced age of 46-60years [AOR:5.27;95%CI(1.18-23.63)] and postoperative hospital stay >8days[AOR:4.20; 95%CI(1.09-16.14)], were statistically associated with unfavourable outcome of stoma reversal operation. Conclusion: In this study, one-third of the patients had postoperative complication of stoma reversal. Colostomy reversal operation, advanced patients’ age and long-time hospital stay were significantly associated with postoperative complication of stoma reversal operation. Therefore, cue due attention should be given to those patients who underwent colostomy reversal operation, and those in advanced age group. This result also calls for all stakeholders to give more emphasis on postoperative hospital stay after stoma reversal.