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A systematic review of patient risk factors for complications following stoma formation among adults undergoing colorectal surgery

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A Correction to this article was published on 20 October 2023

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Abstract

Background

Stoma formation is a commonly performed procedure both during and following colorectal surgery. When designed correctly, stomas can dramatically improve patients’ quality of life, but the reverse may occur when complications arise. Given the significant negative impact of complications following stoma formation, understanding risk factors that may be mitigated pre-operatively is important.

Method

A systematic search of publications using MEDLINE, CINAHL, and Cochrane databases was conducted in May 2022. Data was extracted and a narrative synthesis undertaken. The evidence-based librarianship (EBL) checklist assessed the methodological quality of the included studies. The systematic review includes various research designs such as randomised controlled trials (RCT), case–control studies, and observational cohort studies written in English. Reviews, conference papers, opinion papers, and those including participants < 18 years old were excluded. No restrictions on the date of publication and study setting were applied.

Results

This review included 17 studies, conducted between 2001 and 2020. The study designs were prospective audit, prospective analysis, retrospective analysis, longitudinal analysis and multivariate analysis of self-reported questionaires/surveys. Twenty-two possible risk factors for the development of stoma complications following stoma formation were identified. These include demographical risk factors, underlying medical condition, type of surgery, elective vs emergency surgery, stoma factors, surgical factors, indications for surgery and factors which may impact healing. Furthermore, high BMI, emergency surgery, and stoma type were identified as the most frequently occurring risk factors.

Conclusion

Given the large number of risk factors identified, the implementation of a risk stratification tool may decrease the incidence and prevalence of stoma complication development. This, in turn, would decrease the associated healthcare-related costs, and negative impact on mortality, length of stay and quality of life.

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Data availability

Due to the study design being a systematic review, supporting data is not available.

Change history

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Authors and Affiliations

  1. School of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland

    Mai Shanley Chan

  2. Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland

    Zena Moore, Declan Patton, Tom O’Connor & Pinar Avsar

  3. School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland

    Zena Moore, Declan Patton, Tom O’Connor & Pinar Avsar

  4. Fakeeh College of Health Sciences, Jeddah, Saudi Arabia

    Zena Moore, Declan Patton & Tom O’Connor

  5. School of Nursing and Midwifery, Griffith University, Queensland, Australia

    Zena Moore, Declan Patton & Tom O’Connor

  6. Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash, Australia

    Zena Moore

  7. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Zena Moore

  8. Lida Institute, Shanghai, China

    Zena Moore & Tom O’Connor

  9. University of Wales, Cardiff, UK

    Zena Moore

  10. National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith, QLD, Australia

    Zena Moore

  11. Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia

    Declan Patton

  12. Beaumont Hospital, Dublin, Ireland

    Deborah McNamara

  13. RCSI University of Medicine and Health Sciences, Dublin, Ireland

    Deborah McNamara

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  1. Mai Shanley Chan
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  2. Zena Moore
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  6. Pinar Avsar
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Contributions

Mai Chan: Conceptualization, Methodology, Software. Mai Chan, Pinar Avsar, Zena Moore, Declan Patton: Data curation, Writing- Original draft preparation. Pinar Avsar, Zena Moore, Declan Patton, Deborah McNamara, Tom O`Connor: Supervision. Mai Chan, Pinar Avsar: Software, Validation. Pinar Avsar, Zena Moore, Declan Patton, Deborah McNamara, Tom O`Connor: Writing- Reviewing and Editing.

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Correspondence to Pinar Avsar.

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Chan, M.S., Moore, Z., Patton, D. et al. A systematic review of patient risk factors for complications following stoma formation among adults undergoing colorectal surgery. Int J Colorectal Dis 38, 238 (2023). https://doi.org/10.1007/s00384-023-04523-5

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