Stoma site extraction does not increase complication rates in robot-assisted colorectal surgery: a single-institution...

There has been varying data on whether stoma-site specimen extraction (SSE) increases the risk of ostomy-related complications versus specimen extraction via a separate incision (non-SSE). Complications may be grouped into early (skin excoriation, stoma retraction or necrosis) and late (hernia, prolapse, stenosis, and ischemia dermatitis) complications. SSE in robotic surgery requires one fewer incision, but its impact on rates of early and late stoma-related complications is unknown. We hypothesized that outcomes are similar between SSE and non-SSE robotic colorectal surgery. A retrospective single-center analysis of patients undergoing robotic colorectal surgery was performed. Adult patients (≥ 18 years) who underwent elective, minimally invasive robotic-assisted colorectal resection with either ileostomy or colostomy creation between January 1, 2017 and December 31, 2021 were included. A multivariable logistic regression was performed to compare the two groups. A total of 95 patients were identified; 68 had stoma-site extraction (SSE) performed. There were no statistically significant differences in early or late complications between the two groups. In multivariable logistic regression analysis, the extraction site was not significantly associated with the risk of post-operative stoma complications within the first year-only age demonstrated a significant association with the risk of stoma complications. SSE was associated with significantly decreased operative time, although this difference may also be due to differences between surgeons. Most patients underwent ostomy reversal within 1 year of ostomy creation. Stoma-site specimen extraction (SSE) is a safe method of specimen removal in patients undergoing robotic colorectal surgery. Increased use of SSE may allow for shorter operative times and allows for colectomies to be performed with one fewer incision. As most patients had a stoma for less than 1 year, we caution against generalizing these results to those expected to have a permanent stoma.