Risk factors for stoma prolapse after laparoscopic loop colostomy

Area of Science:

• Abdominal Surgery
• Surgical Complications
• Stoma Care

Background:

• Stoma prolapse (SP) is a frequent complication following colostomy procedures.
• Laparoscopic loop colostomy is associated with a notable incidence of stoma-related issues.
• Identifying risk factors for SP is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate potential risk factors associated with stoma prolapse development after laparoscopic loop colostomy.
• To identify patient and surgical characteristics that predict the occurrence of SP.
• To provide evidence-based recommendations for preventing stoma prolapse.

Main Methods:

• Retrospective analysis of data from 140 patients who underwent laparoscopic loop colostomy between September 2016 and March 2022.
• Multivariate analysis was employed to identify independent risk factors for stoma prolapse.
• Patient demographics, body mass index, and surgical site characteristics were evaluated.

Main Results:

• Stoma prolapse occurred in 33 (23.6%) patients during a median follow-up of 12.5 months.
• Being overweight (BMI ≥ 25) was a significant independent risk factor for SP (OR, 8.69; p=0.012).
• Penetration through a thinner rectus abdominis muscle (< 8.9 mm) was also an independent risk factor (OR, 8.22; p < 0.001).

Conclusions:

• Overweight status and stoma construction through a thinner rectus abdominis are significantly associated with increased SP incidence.
• These factors are independent predictors of stoma prolapse following laparoscopic loop colostomy.
• Selecting a stoma site with thicker rectus abdominis penetration may be key in preventing stoma prolapse.