SJLA_2024_A4: Surgical Outcomes and Stoma-related Complications in Inflammatory Bowel Disease in Saudi Arabia: A Retrospective Study

Background: The prevalence of inflammatory bowel diseases (IBD), Crohn’s (C), and ulcerative colitis (UC) has increased in Saudi Arabia during the past decade. Even though medical treatment is first-line therapy, most patients require surgery during the course of the disease. Stoma-creation complications in IBD are underreported in the literature of the Middle East, especially in Saudi Arabia. Objectives: The objective of the study was to report the postoperative, stoma and peristomal complications following stoma creation in (C) versus UC. Design: The study design was a retrospective cohort study. Settings: The study was conducted at tertiary care center. Patients and Methods: Patients with IBD who underwent stoma creation for either UC or CD between August 2015 and July 2020 were included. The diseases were compared to assess their characteristics and association with postoperative, stoma, and peristomal complications. All complications were reported over a 90-day duration from the surgery. Patients younger than 14 years of age were excluded. Main Outcome Measures: Postoperative complications, stoma, and peristomal complications in IBD patients who underwent stoma creation. Sample Size: Fifty. Results: Of 50 IBD patients underwent stoma creation, 32 patients (64%) were diagnosed with CD and 18 patients (36%) with UC. Most of the procedures in both groups were laparoscopic and elective. Low body mass index and serum albumin were more prevalent in the CD group. Postoperative complications were higher in the CD patients compared to the UC patients (CD 40.6% vs. UC 11.1%, P = 0.028) with the most common complication being abdominal collection(a). Stoma complications were comparable between the two groups (UC 16.7% vs. CD 15.6%). However, peristomal complications were higher clinically in UC patients in comparison with the CD patients (UC 61.1% vs. CD 37.5% P = 0.095) with the most common complication being skin excoriation (UC 44.4% vs. CD 37.5%). Conclusion: CD has significantly higher postoperative complications compared to UC. Peristomal complications were high in both groups and had a negative impact on quality of life. Therefore, comprehensive stoma education and regular outpatient follow-ups are recommended to improve the overall outcomes. Limitations: This study was retrospective and conducted in one academic institution with a small sample size.