Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of laparoscopic surgery for loop colostomy: a propensity-score-matched analysis

  • Original Article
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Purpose

Colostomy is a common procedure for fecal diversion, but the optimal colostomy approach is unclear in terms of surgical outcomes and stoma-related complications. The purpose of this study was to examine the efficacy and feasibility of laparoscopic loop colostomy.

Methods

This retrospective cohort study included patients who underwent loop colostomy at Shizuoka Cancer Center in Japan between April 2010 and March 2022. Patients were divided into two groups based on surgical approach: the laparoscopic (LAP) and open (OPEN) groups. Surgical outcomes and the incidences of stoma-related complications such as stomal prolapse (SP), parastomal hernia (PSH), and skin disorders (SD) were compared with and without propensity score matching.

Results

Of the 388 eligible patients, 180 (46%) were in the LAP group and 208 (54%) were in the OPEN group. The male-to-female ratio was 5.5:4.5 in the Lap group and was 5.3:4.7 in the OPEN group, respectively. The median age was 68 years (range, 31–88 years) in the LAP group and 65 years (range, 23–93 years) in the OPEN group, respectively. The LAP group, compared with the OPEN group, had a shorter operative time and lower incidences of surgical site infection (3.9% versus 16.3%, respectively; p < 0.01) and SD (11.7% versus 24.5%, respectively; p < 0.01). There was no significant difference between the LAP and OPEN groups in the incidence of SP (17.3% versus 17.3%, respectively) or PSH (8.9% versus 6.7%, respectively). After propensity score matching, the incidences of surgical site infection and SD were significantly lower in the LAP group than in the OPEN group, while there were no significant differences in the operative time or the incidences of SP and PSH.

Conclusion

Our results suggest that laparoscopic surgery could be beneficial and feasible in loop colostomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets generated during and analyzed during this study are available from the corresponding author on reasonable request.

References

  1. Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, Sugihara K, Watanabe M, Moriya Y, Kitano S, Japan Clinical Oncology Group Colorectal Cancer Study G (2014) Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg 260:23-30

  2. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, Group COcLoORS (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    Article  PubMed  Google Scholar 

  3. McCombie AM, Frizelle F, Bagshaw PF, Frampton CM, Hewett PJ, McMurrick PJ, Rieger N, Solomon MJ, Stevenson AR, group ALT (2018) The ALCCaS trial: a randomized controlled trial comparing quality of life following laparoscopic versus open colectomy for colon cancer. Dis Colon Rectum 61:1156–1162

    Article  PubMed  Google Scholar 

  4. Unruh KR, Bastawrous AL, Bernier GV, Flum DR, Kumar AS, Moonka R, Thirlby RC, Simianu VV (2021) Evaluating the regional uptake of minimally invasive colorectal surgery: a report from the surgical care outcomes assessment program. J Gastrointest Surg 25:2387–2397

    Article  PubMed  Google Scholar 

  5. Gorgun E, Gezen FC, Aytac E, Stocchi L, Costedio MM, Remzi FH (2015) Laparoscopic versus open fecal diversion: does laparoscopy offer better outcomes in short term? Tech Coloproctol 19:293–300

    Article  CAS  PubMed  Google Scholar 

  6. Ivatury SJ, Bostock Rosenzweig IC, Holubar SD (2016) Short-term outcomes after open and laparoscopic colostomy creation. Dis Colon Rectum 59:543–550

    Article  PubMed  Google Scholar 

  7. Hayashi K, Kotake M, Hada M, Sawada K, Oshima M, Kato Y, Oyama K, Hara T (2017) Laparoscopic versus open stoma creation: a retrospective analysis. J Anus Rectum Colon 1:84–88

    Article  PubMed  Google Scholar 

  8. Kwiatt M, Kawata M (2013) Avoidance and management of stomal complications. Clin Colon Rectal Surg 26:112–121

    Article  PubMed  PubMed Central  Google Scholar 

  9. Babakhanlou R, Larkin K, Hita AG, Stroh J, Yeung SC (2022) Stoma-related complications and emergencies. Int J Emerg Med 15:17

    Article  PubMed  PubMed Central  Google Scholar 

  10. Taneja C, Netsch D, Rolstad BS, Inglese G, Lamerato L, Oster G (2017) Clinical and economic burden of peristomal skin complications in patients with recent ostomies. J Wound Ostomy Continence Nurs 44:350–357

    Article  PubMed  PubMed Central  Google Scholar 

  11. Davis BR, Valente MA, Goldberg JE, Lightner AL, Feingold DL, Paquette IM, Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of C, Rectal S (2022) The American Society of Colon and Rectal Surgeons clinical practice guidelines for ostomy surgery. Dis Colon Rectum 65:1173–1190

    Article  PubMed  Google Scholar 

  12. American Society of Colon and Rectal Surgeons Committee Members; Wound Ostomy Continence Nurses Society Committee Members (2007) ASCRS and WOCN joint position statement on the value of preoperative stoma marking for patients undergoing fecal ostomy surgery. J Wound Ostomy Continence Nurs 34:627–628

  13. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196

    Article  PubMed  Google Scholar 

  14. National Healthcare Safety Network, Centers for Disease Control and Prevention (CDC). (2023) Surgical site infection (SSI) event. https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf

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

    Article  CAS  PubMed  Google Scholar 

  16. Hino H, Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, Numata M, Furutani A, Suzuki T, Torii K (2017) Relationship between stoma creation route for end colostomy and parastomal hernia development after laparoscopic surgery. Surg Endosc 31:1966–1973

    Article  PubMed  Google Scholar 

  17. Martins L, Down G, Andersen BD, Nielsen LF, Hansen AS, Herschend NO, Storling Z (2022) The ostomy skin tool 2.0: a new instrument for assessing peristomal skin changes. Br J Nur 31:442–450

    Article  Google Scholar 

  18. Krishnamurty DM, Blatnik J, Mutch M (2017) Stoma complications. Clin Colon Rectal Surg 30:193–200

    Article  PubMed  PubMed Central  Google Scholar 

  19. Shabbir J, Britton DC (2010) Stoma complications: a literature overview. Colorectal Dis 12:958–964

    Article  CAS  PubMed  Google Scholar 

  20. Husain SG, Cataldo TE (2008) Late stomal complications. Clin Colon Rectal Surg 21:31–40

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tsujinaka S, Tan KY, Miyakura Y, Fukano R, Oshima M, Konishi F, Rikiyama T (2020) Current management of intestinal stomas and their complications. J Anus Rectum Colon 4:25–33

    Article  PubMed  PubMed Central  Google Scholar 

  22. Carne PW, Robertson GM, Frizelle FA (2003) Parastomal hernia. Br J Surg 90:784–793

    Article  CAS  PubMed  Google Scholar 

  23. Chudner A, Gachabayov M, Dyatlov A, Lee H, Essani R, Bergamaschi R (2019) The influence of diverting loop ileostomy vs. colostomy on postoperative morbidity in restorative anterior resection for rectal cancer: a systematic review and meta-analysis. Langenbecks Arch Surg 404:129–139

    Article  CAS  PubMed  Google Scholar 

  24. Du R, Zhou J, Tong G, Chang Y, Li D, Wang F, Ding X, Zhang Q, Wang W, Wang L, Wang D (2021) Postoperative morbidity and mortality after anterior resection with preventive diverting loop ileostomy versus loop colostomy for rectal cancer: a updated systematic review and meta-analysis. Eur J Surg Oncol 47:1514–1525

    Article  PubMed  Google Scholar 

  25. Lyerly HK, Mault JR (1994) Laparoscopic ileostomy and colostomy. Ann Surg 219:317–322

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Edwards DP, Leppington-Clarke A, Sexton R, Heald RJ, Moran BJ (2001) Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial. Br J Surg 88:360–363

    Article  CAS  PubMed  Google Scholar 

  27. Shiraishi T, Nishizawa Y, Nakajima M, Kado R, Ikeda K, Tsukada Y, Sasaki T, Ito M (2020) Risk factors for the incidence and severity of peristomal skin disorders defined using two scoring systems. Surg Today 50:284–291

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    S. Arai, Y. Yamaoka, A. Shiomi, H. Kagawa, H. Hino, S. Manabe, K. Chen, K. Nanishi & C. Maeda

  2. Clinical Research Promotion Unit, Shizuoka Cancer Center, Shizuoka, Japan

    A. Notsu

  3. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    S. Arai & Y. Kinugasa

Authors
  1. S. Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Yamaoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Shiomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Kagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Hino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Manabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K. Nanishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Notsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Y. Kinugasa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y. Yamaoka.

Ethics declarations

Conflict of interest

Drs. Sodai Arai, Yusuke Yamaoka, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, Kai Chen, Kenji Nanishi, Chikara Maeda, Akifumi Notsu, and Yusuke Kinugasa have no conflicts of interest or financial ties to disclose.

Ethical approval

The study was approved by the local institutional review board.

Informed consent

For this type of study, formal consent is not required.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arai, S., Yamaoka, Y., Shiomi, A. et al. Efficacy of laparoscopic surgery for loop colostomy: a propensity-score-matched analysis. Tech Coloproctol 27, 1319–1326 (2023). https://doi.org/10.1007/s10151-023-02856-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-023-02856-5

Keywords

Search

Navigation