Digestive Stomas: Management And Impact On Quality Of Life At The Chu Du Point-G Et Gabriel Toure Bamako (Mali)

Abstract

Purpose: To describe the management and impact of digestive stoma on the quality of life of patients at Point-G and Gabrièl Touré University Hospital.
Patients and method: This was a multicenter, prospective and analytical study of patients with digestive stomas at Point-G and Gabrièl Touré University Hospital, from January 2019 to December 2020.
Results: Forty-one cases of patients with a digestive stoma were collected, 1.65% of the surgical activity of the department. The average age was 47.51 years with extremes of 20 and 96 years. Among these patients, 65.9% were male, i.e. a sex ratio of 1.93. Advice on the wearing of the stoma was given to 31.7% of patients. Information on stoma management was given to 5.12% of patients. Twenty-six (26) patients, i.e. 63.4%, underwent emergency surgery. Peritonitis due to perforation of hollow organs and cancer were the main indications with 83% of cases. The early postoperative follow-up was marked by parietal suppuration (24.4%) and late by peri-stomial skin irritation (26.8% of cases). The plastic bag was used for the stoma appliance in 65.9% of patients. The non-availability of the appliance was the major problem in 63.4% of cases. Stoma care was provided by the next of kin in 75.6% of cases. Lack of hygiene was the problem in 46.3% of cases. The majority of patients (56.1%) were satisfied after the continuity was restored. The cost of management was considered unbearable by 78% of patients. The stoma was considered traumatic in 34.2% of cases. The length of hospital stay was less than one month in 65.9% of cases. The management was evaluated as very good in 39% of the patients.
Conclusion : The digestive stoma induces a real upheaval in the daily life of the patient and leads to multiple physical and psychological changes for the patient and his family, which are inevitable and often difficult to live with. This calls for efforts to help ostomy patients to adapt to a better life.