EP2034 - The Incidence and Complications of Ileostomies and Colostomies in Kuwait: First Insights from the Middle East and Arabian Peninsula

Purpose/Background: Stomas are essential surgical interventions for various gastrointestinal disorders. Despite advances in surgical techniques and postoperative care, stoma-related complications remain common worldwide, with reported rates ranging from 10-70%. These complications are influenced by multiple factors, including patient age, comorbidities, and stoma type. To date, data from the Middle East-and particularly the Arabian Peninsula-are scarce, where extreme temperatures and humidity may alter the incidence and spectrum of complications. This study, the first of its kind in the region, evaluates these outcomes at a tertiary care center and compares them with global trends.

Methods/Interventions: We conducted a retrospective review of 107 patients who underwent stoma creation at a tertiary care center between 2022 and 2025. Data collected from medical records included demographics, comorbidities, surgical details (type, technique), postoperative complications, and stoma reversal rates.

Results/Outcomes: Among 107 patients (mean age 55.8 ± 17.1 years; 51.4% male), 55 (51.4%) underwent ileostomy and 52 (48.6%) colostomy. Ileostomy patients were younger (52.3 ± 19.2 vs. 59.5 ± 13.8 years, p< 0.05) and more likely to have inflammatory bowel disease (25.5% vs. 1.9%, p< 0.05). The overall complication rate was 55%, comprising 37% major and 28% minor complications. High-output stoma was the most frequent complication (32.7%), occurring more often in ileostomy than colostomy patients (45.5% vs. 19.2%, OR=3.50, 95% CI 1.47-8.36, p=0.004). Other complications included peristomal skin irritation (21.5%), stoma stenosis (4.7%), parastomal hernia (3.7%), stoma retraction (3.7%), necrosis (2.8%), and prolapse (1.9%), with no significant intergroup differences. Stoma reversal was over four times more common in ileostomy than colostomy patients (32.7% vs. 9.6%, OR=4.57, 95% CI 1.55-13.47, p=0.004), with mean time to closure of 6.96 months (ileostomy 6.2 vs. colostomy 8.6 months, p=0.084). Multivariate analysis revealed that diabetic patients were significantly more likely to develop high-output stomas (OR=5.0, 95% CI 1.20-20.90, p=0.024).

Conclusion/Discussion: This is the first study from the Middle East, and specifically the Arabian Peninsula, to report on the incidence and complications of stoma creation. The types and frequencies of postoperative complications largely mirror those reported internationally, suggesting effective local adaptations to climate and care practices. These findings support the development of unified international guidelines, rather than region-specific protocols, to optimize stoma care and reduce postoperative complications.