Risk factors for stoma prolapse after laparoscopic loop colostomy

Yusuke Takashima, Hitoshi Hino, Akio Shiomi, Hiroyasu Kagawa, Shoichi Manabe, Yusuke Yamaoka, Chikara Maeda, Shunsuke Kasai, Yusuke Tanaka
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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.

Graphical abstract

Abstract Image

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腹腔镜环状结肠造口术后造口脱垂的风险因素
背景造口脱垂(SP)是一种常见的造口相关并发症,尤其是在襻式结肠造口术中。本研究旨在调查腹腔镜襻式结肠造口术后发生SP的潜在风险因素。方法分析了2016年9月至2022年3月期间接受腹腔镜襻式结肠造口术的140名患者的数据。结果 结肠切除术后的中位随访时间为12.5个月,33例(23.6%)患者发生了SP。多变量分析表明,超重(体重指数≥25;几率比[OR],8.69;95%保密区间[CI],1.61-46.72;P = 0.012)和腹直肌薄穿透造口(< 8.9 mm;OR,8.22;95% CI,2.50-27.05;P < 0.001)是SP的独立风险因素。结论 超重和造口术中穿透较薄腹直肌的路径与腹腔镜环状结肠造口术后SP发生率显著升高有关。选择能穿透较厚腹直肌的施工部位可能是预防 SP 的关键。
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