Risk factors for stoma outlet obstruction: systematic review and meta-analysis.
Ali Toffaha1,2, Ahmed Badr3,4, Mahmood Al-Dhaheri5
1Colorectal Surgery Unit, General Surgery Department, Hamad Medical Corporation, Doha, Qatar. atoffaha2@gmail.com.
Langenbeck'S Archives of Surgery
|October 29, 2025
Summary
Stoma outlet obstruction (SOO) is a serious complication. Key risk factors include increased rectus abdominis muscle thickness, high output stoma, and loop ileostomy, necessitating tailored surgical techniques and vigilant postoperative care to improve patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Complications
- Evidence-Based Medicine
Background:
- Stoma outlet obstruction (SOO) is a significant postoperative complication with substantial morbidity.
- It leads to prolonged hospital stays, increased healthcare costs, and reduced quality of life.
Purpose of the Study:
- To conduct the first systematic review and meta-analysis on SOO.
- Identify and analyze key risk factors, pooled incidence, diagnostic features, symptoms, imaging, management, and outcomes of SOO.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
- Included 16 retrospective cohort studies with data on SOO risk factors.
- Utilized the quality effects model for data synthesis and bias evaluation.
Main Results:
- Identified increased rectus abdominis muscle thickness (OR 4.04), high output stoma (OR 4.16), and loop ileostomy (OR 6.53) as significant SOO risk factors.
- Analyzed data from 2,228 patients, with 362 developing SOO.
- Age was not found to be a statistically significant risk factor (OR 1.69).
Conclusions:
- Significant SOO risk factors include increased rectus abdominis muscle thickness, high output stoma, and loop ileostomy.
- Other contributing factors include ileal pouch-anal anastomosis and higher BMI.
- Tailored surgical techniques and optimized postoperative care are crucial for reducing SOO incidence and improving outcomes.
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