Risk factors for stoma prolapse after laparoscopic loop colostomy

Surg Endosc. 2024 May;38(5):2834-2841. doi: 10.1007/s00464-024-10802-1. Epub 2024 Apr 11.

Abstract

Background: Stoma prolapse (SP) is a common stoma-related complication, particularly in loop colostomies. This study aimed to investigate potential risk factors for SP development after laparoscopic loop colostomy.

Methods: In total, data from 140 patients who underwent laparoscopic loop colostomy were analyzed between September 2016 and March 2022. Risk factors for SP were investigated retrospectively.

Results: The median follow-up duration after colostomy was 12.5 months, and SP occurred in 33 (23.6%) patients. Multivariate analysis showed that being overweight (body mass index ≥ 25; odds ratio [OR], 8.69; 95% confidential interval [CI], 1.61-46.72; p = 0.012) and having a thin rectus abdominis penetration of the stoma (< 8.9 mm; OR, 8.22; 95% CI, 2.50-27.05; p < 0.001) were independent risk factors for SP. Other patient characteristics and surgical factors associated with stoma construction were unrelated to SP development.

Conclusions: Being overweight and the route penetrating the thinner rectus abdominis during stoma construction was associated with a significantly higher incidence of SP after laparoscopic loop colostomy. Selecting a construction site that penetrates the thicker rectus abdominis muscle may be crucial for preventing SP.

Keywords: Laparoscopic surgery; Loop colostomy; Risk factors; Stoma prolapse.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colostomy* / adverse effects
  • Colostomy* / methods
  • Female
  • Humans
  • Incidence
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Overweight / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prolapse
  • Rectus Abdominis
  • Retrospective Studies
  • Risk Factors
  • Surgical Stomas* / adverse effects