Complications of Digestive Stomas: A Retrospective, Descriptive, and Analytical Study of 52 Cases at the Department of Visceral Surgery II, Mohammed V Military Teaching Hospital (HMIMV), Rabat, Morocco

Abstract: Background and Significance: A digestive stoma, whether temporary or permanent, is a surgical procedure commonly performed in gastrointestinal surgery and is essential in the treatment of various conditions such as gastrointestinal cancers, abdominal emergencies, and chronic inflammatory bowel diseases. Although life-saving, this procedure remains associated with a substantial risk of both early and late postoperative complications. The increasing incidence of gastrointestinal cancers and diagnostic delays in certain regions reinforce the need for optimized management and a thorough understanding of the risk factors associated with complications. The primary objective of this study was to assess the complications associated with digestive stomas, whether early or late, while identifying the risk factors that may influence their occurrence. It also aimed to analyze patient characteristics, operative settings, and types of stomas in order to provide useful data for optimizing preoperative and postoperative management. This information could contribute to better prevention of complications and improved clinical outcomes in patients with digestive stomas. The primary objective of this study was to assess the complications associated with digestive stomas, whether early or late, while identifying the risk factors that may influence their occurrence. It also aimed to analyze patient characteristics, operative settings, and types of stomas in order to provide useful data for optimizing preoperative and postoperative management. This information could contribute to better prevention of complications and improved clinical outcomes in patients with digestive stomas. Methods: This retrospective, descriptive, and analytical study was conducted in our department and included 52 patients who underwent creation of a digestive stoma. Data were collected from medical records, telephone calls, and electronic archives, and were analyzed with consideration of patient-related characteristics, surgical factors, and the complications that occurred. Data collection was performed using Excel and analysis using SPSS, and the results were compared with the available scientific literature to better contextualize the conclusions. Results: The overall rate of stoma-specific complications was 39.2%, of which 60% were early complications (bowel obstruction, retraction, and stomal necrosis) and 40% were late complications (parastomal hernia and prolapse). The study identified significant comorbidities, including arterial hypertension (p = 0.004), diabetes (p = 0.006), a high ASA score (p = 0.02), and impaired nutritional status (p = 0.001), as major risk factors. By contrast, other parameters, such as sex and operative setting (emergency or elective), showed no statistically significant association. Conclusion: The findings highlight the crucial importance of a careful preoperative assessment that incorporates patients’ comorbidities and nutritional status in order to prevent complications associated with digestive stomas. However, additional studies with larger cohorts are required to validate these findings and improve management strategies, particularly regarding stoma reversal and the management of late complications.