Surgical techniques and stoma-related complications associated with emergency stoma creation

Abstract

Background Determination of risk factors for stoma-related complications associated with emergency stoma creation may impact reducing complications and improving the quality of life of ostomy patients; however, there are few reports on stoma-related complications associated with emergency stoma creation. Our study aimed to identify the risk factors associated with stoma-related complications after emergency surgery, and evaluate surgical techniques for good stoma creation in the emergency setting.Methods A retrospective analysis of patient and surgical characteristics was performed in 104 consecutive patients who underwent ileostomy or colostomy as emergency surgery between January 2020 and December 2022. Univariate and multivariate analyses of patient and surgical characteristics were conducted to compare cases with and without stoma-related complications during emergency stoma creation.Results Preoperative stoma site marking was performed in 70 (67.3%) patients. Colostomies and ileostomies were performed in 78 (75.0%) and 26 (25.0%) patients, respectively. The skin bridge technique was used in 13 (12.5%) patients. There were 62 (59.6%) patients who were diagnosed with stoma-related complications. Peristomal skin disorders (47.1%) were the most common complication, followed by mucocutaneous separation (31.7%) and stoma retraction (19.2%). Body mass index (BMI) (odds ratio [OR], 5.570; 95% confidence interval [CI], 1.233–25.167; p = 0.026), skin bridge technique (OR, 0.144; 95% CI, 0.031–0.670; p = 0.014), and stoma height (OR: 0.134, 95% CI: 0.038–0.469, p = 0.002) were independent risk factors for stoma-related complications after emergency stoma creation in the multivariable analysis.Conclusions In emergency stoma creation, higher BMI and lower stoma height are associated with stoma-related complications. Furthermore, using the skin bridge technique could reduce the risk of stoma-related complications after emergency stoma creation.