Stomal Prolapse Due to Sidedness of Transverse Loop Colostomy: A Retrospective Cohort Study

Objectives: Stomal prolapse (SP) is one of the most common complications of loop colostomy and can impair a patient's quality of life. Herein, we evaluated the risk factors for SP to prevent its occurrence after a transverse loop colostomy.Methods: This retrospective study included 84 patients who underwent loop transverse colostomy between January 2016 and December 2020. We evaluated the incidence of SP and examined the relationship be-tween perioperative factors and SP using univariate and multivariate logistic regressions.Results: SP occurred in 11 (13.0%) patients. Median time to SP was 99 postoperative days. In the univari-ate analysis, a right side abdominal wall stoma site, perioperative chemotherapy, and anti-VEGF antibody therapy were associated with a significantly higher incidence of SP. Multivariate analysis identified that construction of a temporary loop colostomy in the right transverse colon during rectal cancer surgery (odds ratio, 5.07; 95% confidence interval, 1.12-22.86) is an independent risk factor.Conclusions: In this study, multivariate analysis showed that the right side of the transverse colon was a risk factor for SP. Therefore, when constructing a transverse colon loop stoma, the stoma should be con-structed in the left transverse colon to prevent SP.