Outcomes of Midline Stoma

Outcomes of Midline Stoma: A Prospective Study.

• Ileostomy or colostomy is a common surgical procedure used for diverting the lower gastrointestinal content away from distal pathology or anastomotic insufficiency. Once the distal problem has been fixed, the plan is to reverse the stoma. However, the reversal of a stoma is associated with complications, including anastomotic leaks, wound infection, and incisional hernias which can reach up to 33-50%.
• The ideal site for a stoma on the abdominal wall depends on several factors, including the patient's anatomy, the type of stoma (colostomy or ileostomy), operative findings, and the patient's preferences. Stomas have traditionally been fashioned through the rectus muscle, away from the midline of the abdomen, and below the umbilicus.

• Management of a stoma placed at the center of a long midline laparotomy wound is challenging with the risk of faecal contamination of midline incision. However in many scenarios, the surgeon is left without options rather than to exteriorize the bowel loop through the midline. Moreover, advantages of midline stoma may include:

  1. Easy to create and save operative time.
  2. Minimize destruction of the anterior abdominal wall (less tissue injury).
  3. Eliminate the long-term risk of incisional hernia at the site of previous stoma.

Only, few reports assess the outcomes of midline ostomy as a temporary stoma

Study Overview

• Status: Recruiting
• Conditions: Stoma Ileostomy; Stoma Colostomy
• Intervention / Treatment: Procedure: Midline stoma

Detailed Description

This is a prospective cohort study

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mohamad Raafat, MD; Phone Number: 0201067877622; Email: mohamad_raafat10@yahoo.com
• Study Contact Backup: Name: Faculty of Medicine-Assiut University

Study Locations

• Egypt
  • Asyut Governorate
    • Asyut, Asyut Governorate, Egypt, 71515
      • Recruiting
      • Faculty of Medicine-Assiut University
      • Contact: Mohamad Raafat, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients who will undergo temporary stoma (ileostomy/colostomy) through midline incision.

Exclusion Criteria:

• Patients with jejunostomy.
• Patients with severe sepsis.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Midline stoma group; Patients who will undergo temporary stoma (ileostomy/colostomy) through midline incision	Procedure: Midline stoma; stoma (ileostomy/colostomy) through midline incision

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Conversion rate	Need for stoma revision (failure of midline stoma) and creation of conventional trans-rectus stoma.	During surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of peristomal skin complications	Number and percentage of patients with peristomal skin complications around stoma including erythema, erosion, ulceration and tissue overgrowth (hypergranulation)	1 month after surgery
Incidence of Incisional hernia after stoma reversal	Number and percentage of patients developing incisional hernia at the previous stoma site (after stoma reversal) confirmed clinically or radiologically (ultrasound or CT)	1 year after surgery

Collaborators and Investigators

• Sponsor: Assiut University

Publications and helpful links

General Publications

• Nguyen MT, Phatak UR, Li LT, Hicks SC, Moffett JM, Arita NA, Berger RL, Kao LS, Liang MK. Review of stoma site and midline incisional hernias after stoma reversal. J Surg Res. 2014 Aug;190(2):504-9. doi: 10.1016/j.jss.2014.01.046. Epub 2014 Jan 29.
• Erwin-Toth P, Barrett P. Stoma site marking: a primer. Ostomy Wound Manage. 1997 May;43(4):18-22, 24-5.
• Eto K, Omura N, Haruki K, Uno Y, Ohkuma M, Nakajima S, Anan T, Kosuge M, Fujita T, Ishida K, Yanaga K. Transumbilical defunctioning ileostomy: A new approach for patients at risks of anastomotic leakage after laparoscopic low anterior resection. Anticancer Res. 2013 Nov;33(11):5011-5.
• Borejsza-Wysocki M, Bobkiewicz A, Ledwosinski W, Szmyt K, Banasiewicz T, Krokowicz L. Stoma close to the abdominal wound: a real technical problem. A description of a novel care strategy. Pol Przegl Chir. 2023 Feb 17;95(4):1-5. doi: 10.5604/01.3001.0016.2731.
• DeVito R, Shoukry S, Yglesias B, Fullmer R, Zarnoth B, Kerestes T. A case of simultaneous abdominal wall reconstruction and creation of diverting ostomy in a ventral hernia with loss of domain. Int J Surg Case Rep. 2020;76:361-363. doi: 10.1016/j.ijscr.2020.10.012. Epub 2020 Oct 7.

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: September 14, 2025
• First Submitted That Met QC Criteria: May 23, 2026
• First Posted (Actual): June 1, 2026

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 23, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: incisional hernia; stoma; midline incision
• Additional Relevant MeSH Terms: Postoperative Complications; Pathologic Processes; Pathological Conditions, Anatomical; Hernia; Pathological Conditions, Signs and Symptoms; Incisional Hernia
• Other Study ID Numbers: RF-2-6-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No