Prolapse of intestinal stoma

• Published in: Journal of Japanese Society of Stoma and Continence Rehabilitation Vol. 37; no. 2; pp. 5 - 14
• Main Author: Maeda, Kotaro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Stoma and Continence Rehabilitation 2021
• Subjects: classification; stoma complication; stoma prolapse
• ISSN: 1882-0115; 2434-3056
• DOI: 10.32158/jsscr.37.2_5

Stomal prolapse can usually be managed conservatively by stoma care nurses. However, when complications due to stoma prolapse make stoma care by nurses difficult, and/or the stoma prolapse affects normal bowel function and induces incarceration, surgical management is considered. If the stoma functions as a fecal diversion, the prolapse is resolved by stoma reversal. Loop stoma prolapse reportedly occurs when increased intraabdominal pressure induces stoma prolapse by pushing the stoma up between the abdominal wall and the intestine, particularly in cases with redundant and mobile colon. Therefore, stoma prolapse repair aims to prevent or eliminate the space between the abdominal wall and intestine, as well as the redundant and mobile intestine. Accordingly, surgical repair methods for stoma prolapse are classified as three types:methods to fix the intestine, methods to shorten the intestine, and methods to eliminate the space between the stoma and the abdominal wall around the stoma orifice. Additionally, the following surgical techniques at the time of stoma creation are reported to be effective in preventing stoma prolapse:avoidance of excessive fascia incision, fixation of the stoma to the abdominal wall, appropriate selection of the intestinal site for the stoma orifice that will minimize redundant intestine, and using an extraperitoneal route for stoma creation.