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Impact of Preoperative Stoma Site Marking on Morbidity and Mortality in Patients with Colorectal Perforation: A Nationwide Retrospective Cohort Study

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Abstract

Background

Preoperative stoma site marking reduces the incidence of complications from elective surgery. However, the impact of stoma site marking in emergency patients with colorectal perforation remains unclear. This study aimed to assess the impact of stoma site marking on morbidity and mortality in patients with colorectal perforation who underwent emergency surgery.

Methods

This retrospective cohort study used the Japanese Diagnosis Procedure Combination inpatient database from April 1, 2012, to March 31, 2020. We identified patients who underwent emergency surgery for colorectal perforation. We compared outcomes between those with and without stoma site marking using propensity score matching to adjust for confounding factors. The primary outcome was the overall complication rate, and the secondary outcomes were stoma-related, surgical, and medical complications and 30-day mortality.

Results

We identified 21,153 patients (682 with stoma site marking and 20,471 without stoma site marking) and grouped them into 682 pairs using propensity score matching. The overall complication rates were 23.5% and 21.4% in the groups with and without stoma site marking, respectively (p = 0.40). Stoma site marking was not associated with a decrease in stoma-related, surgical, or medical complications. The 30-day mortality did not differ significantly between the groups with and without stoma site marking (7.9% vs. 8.4%, p = 0.843).

Conclusions

Preoperative stoma site marking was not associated with a reduction in morbidity and mortality in patients with colorectal perforation who underwent emergency surgery.

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Acknowledgements

None.

Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007 and 22AA2003), and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907).

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Authors and Affiliations

  1. Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City, Tochigi, 329-0498, Japan

    Jun Watanabe, Atsushi Miki, Hisanaga Horie & Naohiro Sata

  2. Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Tochigi, Japan

    Jun Watanabe & Kazuhiko Kotani

  3. Data Science Center, Jichi Medical University, Shimotsuke-City, Tochigi, Japan

    Yusuke Sasabuchi

  4. Department of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Tokyo, Japan

    Yusuke Sasabuchi

  5. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Tokyo, Japan

    Hiroyuki Ohbe, Mikio Nakajima, Hiroki Matsui & Hideo Yasunaga

  6. Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan

    Mikio Nakajima

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  1. Jun Watanabe
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  2. Yusuke Sasabuchi
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  6. Atsushi Miki
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  9. Hideo Yasunaga
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  10. Naohiro Sata
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Correspondence to Jun Watanabe.

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Conflict of interest

The authors declare no conflicts of interest.

Ethics approval

The study was approved by the Institutional Review Board of The University of Tokyo (approval number: 3501-[5] [May 19, 2021]).

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The requirement for informed consent was waived because of the anonymous nature of the data.

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Watanabe, J., Sasabuchi, Y., Ohbe, H. et al. Impact of Preoperative Stoma Site Marking on Morbidity and Mortality in Patients with Colorectal Perforation: A Nationwide Retrospective Cohort Study. World J Surg 47, 2857–2864 (2023). https://doi.org/10.1007/s00268-023-07090-6

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  • DOI: https://doi.org/10.1007/s00268-023-07090-6

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