Efficacy of laparoscopic surgery for loop colostomy: a propensity-score-matched analysis

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Surgical Outcomes Research

Background:

• Colostomy is a common fecal diversion technique.
• Optimal surgical approach and associated complications remain unclear.
• Stoma-related issues include prolapse, hernia, and skin disorders.

Purpose of the Study:

• To evaluate the efficacy and feasibility of laparoscopic loop colostomy.
• To compare surgical outcomes and complication rates between laparoscopic and open approaches.

Main Methods:

• Retrospective cohort study of 388 patients undergoing loop colostomy (April 2010-March 2022).
• Comparison between laparoscopic (LAP) and open (OPEN) surgical groups.
• Analysis of surgical outcomes and stoma complications (stomal prolapse, parastomal hernia, skin disorders) with propensity score matching.

Main Results:

• The LAP group (n=180) had shorter operative times and lower incidences of surgical site infection (3.9% vs 16.3%) and skin disorders (11.7% vs 24.5%) compared to the OPEN group (n=208).
• No significant differences were observed in stomal prolapse (17.3% vs 17.3%) or parastomal hernia (8.9% vs 6.7%) rates.
• Post-propensity score matching, lower surgical site infection and skin disorder rates persisted in the LAP group.

Conclusions:

• Laparoscopic loop colostomy demonstrates significant benefits.
• The procedure is both feasible and advantageous for patients.
• Reduced infection and skin complications highlight the value of the laparoscopic approach.