Preoperative stoma site marking: a simple practice to reduce stoma-related complications

Background To evaluate the incidence and identify the risk factors of stoma-related complications in a consecutive series of patients treated at a single institution. Methods For this retrospective analysis, the medical records of patients followed up at the stoma care centre of our institution over the last 16 years were reviewed. The primary end point was the incidence of stoma-related complications. Risk factors were tested using univariate and multivariate Cox proportional hazards models. Results Of a total of 1076 patients, 604 received a colostomy and 472 an ileostomy. In all, 1055 stoma-related complications were recorded in 797 patients. Univariate analysis identified the following risk factors for stoma-related complications: male sex (p=0.032), emergency surgery (p=0.010), open surgery (p<0.001), and ileostomy creation (p=0.004). Preoperative stoma site marking was noted to play a protective role (hazard ratio 0.739; 95% confidence interval 0.576-0.947; p=0.017). Multivariate analysis confirmed male sex and ileostomy creation as risk factors (p=0.030 and p=0.013, respectively) and preoperative stoma site marking as an independent protective factor (p=0.001). Conclusions Stoma-related complications are quite common, especially when an ileostomy is present. Preoperative stoma site marking was noted to play a highly protective role not only in reducing the complication rate but also in improving the patients' quality of life.