ArticleWorld journal of emergency surgery : WJES2025
Stoma reversal after emergency stoma formation-the importance of timing: a multi-centre retrospective cohort study.
Article in World journal of emergency surgery : WJES, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Clinical spotlight review: best practices for the management of colorectal cancer in the emergency and acute care setting.Surgical endoscopy · 2026Review
- Hartmann's procedure reversal rate and short-term outcomes: a single centre retrospective cohort study.BMC surgery · 2026Article
- Reversal of Hartmann's procedure: The impact of timing - a single-tertiary-center experience.Surgery in practice and science · 2025Article
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Authors and funding
7 authors.
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Abstract
backgroundRestoration of intestinal continuity is a key consideration for patients having a stoma created under emergency conditions. There is contrasting evidence about the outcomes of stoma reversal for these patients. This research aims to describe the post-operative outcomes of stoma reversal after emergency formation, and whether these are affected by the timing of reversal.
methodsA retrospective review of a prospectively maintained emergency laparotomy (EmLap) database for 4 hospitals was performed between 2018 and 2021. Adult patients undergoing emergency stoma formation were identified and followed up until 2024. Those undergoing stoma reversal surgery were included in the final analysis. A Cox proportional-hazards model was created to identify factors associated with increased time to reversal.
results1775 patients had an EmLap, with 505 (28.5%) having a stoma created. Of those patients with a stoma, 97 patients (19.2%) died within one year post-operatively. 146 (28.9%) of the emergency stoma patients underwent stoma reversal, with median time to reversal of 16.9 months. Median post-operative length of stay was 7 days, and 52.1% of patients sustained complications within 30 days post-operatively. Patients reversed within 18 months of stoma formation had fewer significant complications (7.9% v 35.1%, p < 0.001), a shorter length of stay (6 days v 7 days, p < 0.001), and reduced post-operative ileus rates (21.3% v 64.9%, p < 0.001) than those reversed after this period. Receiving adjuvant therapy for malignancy (adjusted Hazard ratio 0.36, 0.17-0.78, p = 0.001) and being male (adjusted Hazard ratio 0.69, 0.49-0.97, p = 0.032) were significantly associated with increased time to reversal.
conclusionEmergency stoma formation is commonly performed during EmLap, but the majority of emergency stomas are never reversed. The complication profile for reversing these stomas is significant, but early reversal is associated with better post-operative outcomes. Standards of care for emergency stoma patients would be welcome in order to improve outcomes for this cohort.
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