Feeding stoma surgery on a nutritional support service.

Thirty patients undergoing feeding stoma operation over a 2 1/2 yr period were managed by the nutritional support service. The policy of preoperative nutritional support of these generally ill and malnourished patients contributed to operative survival and discharge from the hospital for 23 patients; only one death 21 days postoperatively was directly attributable to the feeding stoma procedure. Nonfatal complications of the surgery occurred in nine cases, and required reoperation in three instances. Early stoma use was the rule, and there were 10 documented cases of long-term stoma use averaging 14 months. Three-month survival of 19 patients (63%), and six-month survival of 13 patients (43%) along with early discharge from the hospital for most patients attest to efficacy and ease of stoma use. An essential feature contributing to diminished postoperative problems was prestoma surgery nutritional support. Continuity of feeding stoma planning and patient care may be best achieved when a nutritional support service is involved through the entire course of management.