The purpose of this multicenter study was to clarify the incidence and severity classification system (J Jpn Soc Coloproctol 64:853, 2011) of early stoma-related complications in gastrointestinal stoma in Japan. Among 2,502 patients who received gastrointestinal stoma construction at 50 institutes in Japan between January and December 2014, 365 patients (14.6%) experienced early stoma-related complications. The most common complications were mucocutaneus dehiscence (224 patients) and necrosis (116 patients). In terms of severity classification, 163 patients had grade 1, 147 patients had grade 2, 42 patients had grade 3, and 7 patients had grade 4 complications. Higher severity grades were significantly related to lower rate of stoma site marking, higher rate of emergent operation, and longer postoperative hospital stay. This study revealed the current status of early stoma-related complications in Japan and indicated the usefulness of this severity classification system of stoma-related complications.

A man in his 80s visited our outpatient stoma clinic complaining of bleeding and pain at his sigmoid colostomy. He had undergone laparoscopic abdominoperineal resection for rectal cancer and developed a parastomal hernia 2 years later. His symptoms were caused by infected granulation tissue and an ulcer at the stoma due to the parastomal hernia. Because his symptoms were not improved by conservative therapies, surgical repair of the parastomal hernia was performed with re-do stoma formation to minimize surgical invasiveness, given his frail condition. At operation, both the infected granulation tissue and stomal ulcer were resected, which caused a large skin defect around the new stoma. The skin defect was successfully closed with a technique of circumferential subcuticular wound approximation, which resulted in creating a new, easy-to-manage stoma at the same site. This successful outcome was achieved by good cooperation between our surgeons and a certified nurse in wound, ostomy, and continence nursing (WOCN). We together decided how to manage this patient’s problems and finally improved his quality of life (QOL). Both cooperation with surgeons and continuous support in the outpatient stoma clinic by the WOCN are essential to achieve the best QOL for patients with stomas.