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Surgical management of stomal prolapse - Is there a superior approach to repair?
Rohin Mittal1, Tarek Jalouta1, Martin Luchtefeld2
1Colorectal Surgery, Spectrum Health/Ferguson Clinic, USA.
Background:
Stomal prolapse is an uncommon complication related to ostomy creation without comparative studies to suggest an optimal approach. Our aim was to assess long-term recurrence rates following surgical repair, specifically local repair vs. laparotomy.
Methods:
We conducted a retrospective review of patients who underwent surgical correction of a prolapsed stoma by dedicated colorectal surgeons. The primary outcome was recurrence. We evaluated perioperative risk factors for long-term recurrence, focusing on the surgical approach.
Results:
Over 12 years, 23 patients underwent 37 surgeries (median follow-up 24 months, range 1-126). Repeat operations for recurrence were performed in 43.5% of patients, 80% within one year. Recurrence was similar regardless of the surgical approach; 43.6% local repair vs 42.9% laparotomy (p = 0.41). Age, sex, body mass index, smoking status, ASA score, type of stoma, and urgency of repair were not associated with recurrence. Re-recurrence resulting in a third operation, occurred in 50% of patients.
Conclusion:
Operative repair of stomal prolapse, regardless of approach, is associated with high recurrence rates. No identifiable factors were associated with recurrence.
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