EP785 - Risk Factors for Stoma Prolapse After Colorectal Surgery: A Qualitative Systematic Review of Clinical and Technical Determinants

Monday, May 11, 2026

8:32 AM - 8:37 AM ET

ePoster Presenter(s)

Ajita Naik, MBBS (she/her/hers)

Resident
Montefiore Medical Center
Montefiore Medical Center
Bronx, NY, United States

Disclosure information not submitted.

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Author(s)

Hongyan Yu, MD

Resident
Montefiore Medical Center
Montefiore Medical Center
BRONX, NY, United States

Disclosure information not submitted.

Author(s)

LV

Laura Vidotto, n/a

Medical doctor
Santa Casa de Misericórdia de Piracicaba
Piracicaba, Sao Paulo, Brazil

Disclosure information not submitted.
RN

Raquel Nogueira, MD

Research Fellow
Montefiore Medical Center
Bronx, New York, United States

Disclosure information not submitted.
MA

Maria Fernanda Andrade, n/a

Medical Student
Universidade Salvador
Salvador, Bahia, Brazil

Disclosure information not submitted.
DA

Denise Almeida, n/a

Medical Student
Centro Universitário Cesmac
Maceió, Alagoas, Brazil

Disclosure information not submitted.
Dante L. S Souza, MD

General Surgery Resident
TriHealth Good Samaritan Hospital
TriHealth Good Samaritan Hospital
Cintinnati, OH, United States

Disclosure information not submitted.
NM

Nandita N. Mahajan, MD

Surgery Resident
Montefiore Medical Center
Bronx, New York, United States

Disclosure information not submitted.
RH

Renee Huang, MD

Surgeon
Montefiore Medical Center
Scarsdale, New York, United States

Disclosure information not submitted.
OW

Othon Wiltz, MD

Assstant Professor of Surgery
Montefiore Einstein
Scarsdale, New York, United States

Disclosure information not submitted.
ID

Isabel C. Dos Santos Marques, MD

General Surgery Resident
DHR/University of Houston
McAllen, Texas, United States

Disclosure information not submitted.

Senior Author(s)

JT

James P. Taylor, MBBChir MPH

Assistant Professor of Surgery
Montefiore Medical Center
New York, New York, United States

Disclosure information not submitted.

Author(s)

AA

Abier a. A. Abdelnaby, FASCRS

surgeon
montefiore medical center
new rochelle, New York, United States

Disclosure information not submitted.

Purpose/Background: Stoma prolapse is a clinically relevant and often underreported complication following colorectal surgery. While multiple technical and anatomical factors have been proposed, evidence remains fragmented and inconsistent. This qualitative systematic review aimed to identify and assess risk factors associated with stoma prolapse, highlighting operative settings, technical features, and preventive strategies.

Methods/Interventions: Following PRISMA guidelines, MEDLINE/PubMed (146), EMBASE (424), and Web of Science (148) were searched through July 26, 2025. Of 718 screened records, 27 underwent full-text review, and 9 met our inclusion criteria. Data regarding patient characteristics, stoma type and configuration, location, surgical context, and preoperative site marking were extracted. Due to the high heterogeneity of the outcomes, a qualitative synthesis was performed.

Results/Outcomes: Nine studies met inclusion criteria, reporting stoma prolapse rates ranging from 0.9% to 23.6%. When stratified by incidence, distinct technical and clinical patterns emerged. Among the five studies reporting prolapse rates >5% (Arai, MacDonald, Takashima, Yano, Ratnasekera), loop configuration predominated in four of these studies, and all cohorts included colostomies (four exclusively). Transverse and sigmoid colostomies were the most frequent locations in four of the five studies, particularly in Takashima (88%) and Yano (100%). Although preoperative site marking was documented in MacDonald (48%), Takashima (100%), and Yano (82%), these series still demonstrated higher prolapse rates, highlighting the influence of loop anatomy and mesenteric mobility. Conversely, the four studies reporting < 5% prolapse (Arolfo, Arumugam, Mahjoubi, Park) shared protective technical features: end colostomy predominance (three of four), sigmoid or descending location, elective creation in at least 73%, and preoperative site marking in all series (ranging from 26% to 100%). Collectively, these findings suggest that loop configuration, emergency creation, and transverse positioning increase the risk of stoma prolapse, whereas elective end colostomies in fixed sigmoid segments with proper site marking are associated with substantially lower incidence.

Conclusion/Discussion: The current literature on stoma prolapse remains limited, heterogeneous, and largely retrospective. However, this qualitative systematic review identified recurrent technical patterns across studies. Loop colostomies, especially those constructed in transverse or sigmoid segments, and emergency procedures without standardized site marking were repeatedly associated with higher prolapse rates. In contrast, elective end colostomies positioned in the sigmoid or descending colon, often with preoperative site marking, appeared to have a lower reported incidence. To guide the development of preventive and predictive strategies, standardized studies are needed to validate these observed trends.