Tube enterostomy requires monitoring the patient for infection or bleeding, and educating him or her on the proper use of the enterostomy. According to the type of surgery—minimally invasive or open surgery—it may take several days for the patient to resume normal functioning. Fluid intake and urinary output must be monitored to prevent dehydration.
Tube enterostomies are not considered high risk surgeries. Insertions have been completed in over 90% of attempts. Possible complications include diarrhea, skin irritation due to leakage around the stoma, and difficulties with tube placement.
Tube enterostomy is becoming more frequent due to great advances in minimally invasive techniques and new materials used for stoma construction. However, one recent radiograph study of 289 patients who had jejunostomy found that 14% of patients suffered one or more complications, 19% had problems related to the location or function of the tube, and 9% developed thickened small-bowel folds.
Recovery without complications is the norm for this surgery. The greatest challenge is educating the patient on proper stoma usage and types of nutritional support that must be used.
Morbidity and mortality rates
Some feeding or tube stomas have the likelihood of complications. A review of 1,000 patients indicated that PEG tube placement has mortality in 0.5%, with major complications (stomal leakage, peritonitis [infection in the abdomen], traumatized tissue of the abdominal wall, and gastric [stomach] hemorrhage) in 1% of cases. Wound infection, leaks, tube movement or migration, and fever occurred in 8% of patients. In a review of seven published studies, researchers found that a single intravenous dose of a broad-spectrum antibiotic was very effective in reducing infections with the stoma. Open surgery always carries with it a small percentage of cardiac complications, blood clots, and infections. Many gastric stoma patients have complicated diseases that increase the likelihood of surgical complications.
Nancy McKenzie Ph.D., The Gale Group Inc., Gale, Detroit,