Prospective evaluation of early local complications of stoma and their risk factors


  • Koustav Jana Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal, India
  • Pritin Bera Department of Surgery, SSKM Hospital and IPGMER, Kolkata, West Bengal, India
  • Arunima Mukhopadhyay Department of Surgery, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
  • Ujjwal Bhattacharya Department of Surgery, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India



Stoma, Ileostomy, Colostomy, Complications, Risk factor


Background: Bowel stoma namely ileostomy and colostomy are frequently performed procedure and often associated with complications. Aim of this study was to assess early local complications and association with any risk factors.

Methods: A total of 99 patients undergoing ileostomy or colostomy were analysed prospectively over a period 18 months. Comorbidity, preoperative clinical data, operative time, local complications within 12 weeks and hospital stay were documented. Univariate and multivariate analysis were used to find out any association.

Results: Sixty-four ileostomies and 35 colostomies were analysed in our study. Median age was 55 years in both groups. Nontraumatic bowel perforation (42%) and colorectal malignancy (48.6%) were most common etiology for ileostomy and colostomy formation respectively.  64% of ileostomy and 68% of colostomy had one or more complications. Skin excoriation (31%) was most common complication in ileostomy group and it was stomal prolapse (17%) in colostomy group. Poor stoma care was prevalent in both groups. We found diabetes to have significant association with skin excoriation (p=0.002).

Conclusions: Diabetes was identified as significant risk factor for skin excoriation in ileostomy group. Further long term data and larger population are needed for better evaluation of stomal complication and their risk factors.

Author Biography

Koustav Jana, Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal, India

Senior Resident

Department of Surgical Gastroenterology

SSKM Hospital and IPGMER



Shabbir J, Britton DC. Stoma complications: a literature overview. Colorectal Dis. 2010;12(10):958-64.

Jonkers HF, Draaisma WA, Roskott AM, Van Overbeeke AJ, Broeders IA, Consten EC. Early complications after stoma formation: a prospective cohort study in 100 patients with 1-year follow-up. Int J Colorectal Dis. 2012;27(8):1095-9.

Harris DA, Egbeare D, Jones S, Benjamin H, Woodward A, Foster ME. Complications and mortality following stoma formation. Annals Royal Coll Surgeon Engl. 2005;87(6):427.

Parmar KL, Zammit M, Smith A, Kenyon D, Lees NP. Greater manchester and cheshire colorectal cancer network: a prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. Colorectal Dis. 2011;13(8):935-8.

Krishnamurty DM, Blatnik J, Mutch M. Stoma complications. Clinic Colon Rectal Surg. 2017;30(3):193-200.

Chaudhary P, Ishaq Nabi GR, Tiwari AK, Kumar S, Kapur A, Arora MP. Prospective analysis of indications and early complications of emergency temporary loop ileostomies for perforation peritonitis. Annals Gastroenterol. 2015;28(1):135.

Pearson R, Knight SR, Ng JC, Robertson I, McKenzie C, Macdonald AM. Stoma-related complications following ostomy surgery in 3 acute care hospitals: a cohort study. J Wound Ostomy Cont Nurs. 2020;47(1):32-8.

Arumugam PJ, Bevan L, Macdonald L, Watkins AJ, Morgan AR, Beynon J, Carr ND. A prospective audit of stomas‐analysis of risk factors and complications and their management. Colorectal Dis. 2003;5(1):49-52.

Robertson I, Leung E, Hughes D, Spiers M, Donnelly L, Mackenzie I, Macdonald A. Prospective analysis of stoma‐related complications. Colorectal Dis. 2005;7(3):279-85.

Lyons AS. Ileostomy and colostomy support groups. Mount Sinai J Med. 2001;68(2):110-2.

Bass EM, Del Pino A, Tan A, Pearl RK, Orsay CP, Abcarian H. Does preoperative stoma marking and education by the enterostomal therapist affect outcome?. Dis Colon Rectum. 1997;40(4):440-2.

Guimarães GC, Terabe F, Rossi BM, Junior SA, Ferreira FO, Nakagawa WT, Lopes A. The double-barreled wet ileostomy: an alternative method for simultaneous urinary and intestinal diversion without intestinal anastomosis after total colectomy and pelvic exenteration. Int J Colorectal Dis. 2005;20(2):190‐3.

Steinhagen E, Colwell J, Cannon LM. Intestinal stomas: postoperative stoma care and peristomal skin complications. Clin Colon Rectal Surg. 2017;30(3):184-92.

Salvadalena G. Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review. J Wound Ostomy Continence Nurs. 2008;35(6):596–607.

Caricato M, Ausania F, Ripetti V, Bartolozzi F, Campoli G, Coppola R. Retrospective analysis of long-term defunctioning stoma complications after colorectal surgery. Colorectal Dis. 2007;9(6):559-61

Leong AP, Londono-Schimmer EE, Phillips RK. Life-table analysis of stomal complications following ileostomy. Br J Surg. 1994;81(5):727-9.

Shellito PC. Complications of abdominal stoma surgery. Dis Colon Rectum. 1998;41(12):1562-72.

Cottam J, Richards K, Hasted A, Blackman A. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Dis. 2007;9(9):834-8.

Murken DR, Bleier JI. Ostomy-related complications. Clin Colon Rectal Surg. 2019;32(3):176-82.

Boyles A. Stoma and peristomal complications: predisposing factors and management. Gastrointestinal Nursing. 2010;8(7):26-36.

Koc U, Karaman K, Gomceli I, Tahsin D, Ilter O, Murat U, et al. A retrospective analysis of factors affecting early stoma complications. Ostomy Wound Manage. 2017;63(1):28-32.

Whitehead A, Cataldo PA. Technical considerations in stoma creation. Clin Colon Rectal Surg. 2017;30(3):162-71.

Sjödahl R, Anderberg B, Bolin T. Parastomal hernia in relation to site of the abdominal stoma. Br J Surg. 1988;75(4):339-41.

Cross AJ, Buchwald PL, Frizelle FA, Eglinton TW. Meta‐analysis of prophylactic mesh to prevent parastomal hernia. Br J Surg. 2017;104(3):179-86.

Kwiatt M, Kawata M. Avoidance and management of stomal complications. Clin Colon Rectal Surg. 2013;26(2):112-21.






Original Research Articles