High-output Stoma Research Articles

Dietary management of patients with a high-output stoma

A stoma enables faeces and flatus to be passed through a small surgically formed aperture in the abdominal wall, and may be temporary or permanent. However, in some cases, the output of a stoma can exceed normal limits. Without appropriate management, a high-output stoma can lead to dehydration, electrolyte disturbances and malnutrition in patients. Interventions to manage a high-output stoma include the use of oral rehydration solutions, restriction of hypotonic fluids and dietary modifications. This article reviews the causes of high-output stomas, and describes the assessment and management options available to nurses.

Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)

PurposePostoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery.MethodsThis prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups).ResultsA total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (P = 0.012 and P = 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (P = 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien–Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%, P = 0.0061).ConclusionsSmoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications.

N18 Introduction of inflammatory bowel disease specialized dietitian and nutritional status in a multidisciplinary IBD team

Abstract Background Qualitative inflammatory bowel disease (IBD) care is marked by a multidisciplinary approach including physicians, nurses, psychologists and dietitians. Specialist IBD dietitians can address the specific needs of patients with IBD, with an emphasis on nutritional status, disease activity, and functional symptoms. We wanted to obtain a snapshot of the IBD population referred to the dietitian at our IBD clinic. Methods Since February 2021, two specialist IBD dietitians were hired at the multidisciplinary IBD-team of our tertiary referral centre. Data from all IBD patients seen by the IBD-dietitians were prospectively collected. Patients with IBD were referred to the IBD dietitians for dietary advice concerning optimization of nutritional status, modulation of diet-induced abdominal symptoms, and IBD-related problems (e.g. high output stoma, obstruction, enteral or parenteral nutrition). Malnutrition as reason for referral was defined as an abnormal body mass index (BMI <18.5 or >25 kg/m²). Results From 1 February 2021 until 16 November 2021, 219 IBD patients (58.4% women, median age 38 years, 127 Crohn’s disease, 92 ulcerative colitis) were seen by the IBD-dietitians. Patient characteristics are described in table 1. A total of 303 contacts were registered, including 82% in-hospital consultations (16% in-patient clinic, 66% outpatient clinic) and 18% remote consultations (via telephone or email). The median BMI at first consultation was 23.49 kg/m2. In this cohort, 46.6% of IBD patients had a normal BMI, 37% were obese or overweight, and 13.2% has underweight. Males had a significantly higher BMI than females (BMI 24.5 vs 22.5 kg/m2, p-value 0.048). The main reasons for referral were IBD-related symptoms or disease activity (46.6%), malnutrition (26%), functional symptoms (16.4%), and patient’s interest in receiving more information on diet (9%). Of note, none of the patients were being treated with enteral nutrition at time of referral, and only 5 patients were being treated with parenteral nutrition. Most patients received dietary advice (92%) and only 1 patient was started with enteral nutrition. Conclusion The introduction of IBD-dietitians in our multidisciplinary IBD care program has allowed IBD-patients with or without malnutrition, to be assessed by a specialist IBD dietitian who can provide appropriate dietary advice. Of note was that despite an already expert IBD center with a multidisciplinary team in place, the prevalence of malnutrition in this selected IBD cohort was very high. Nevertheless, IBD disease activity and IBD-related symptoms were the main reason for referral to the IBD-dietitian, reflecting the need for tailored nutritional advice complementary to medical or surgical treatment.

Assessment of the importance of ostomy patients’ understanding of dietary and lifestyle recommendations

Objective: the objective of our study was to evaluate the level of understanding of ostomy patients regarding lifestyle, diet, and high output stoma (HOS) management recommendations provided by healthcare professionals. Method: a prospective study to follow up ostomy patients at nutritional consultations was designed. The follow-up process was performed 7-10 days after hospital discharge and again one month later. At the first visit, patients were instructed in the detection and management of HOS. At the second visit, the level of understanding of the training received was assessed using an evaluation questionnaire. A descriptive analysis of the answers to each of the questionnaire's items was performed. Fisher's exact test was used to evaluate differences in the level of understanding recorded with the questionnaire. Results: a total of 35 patients were recruited; 71.4 % did not provide correct answers to all the questions. There were no significant differences in the correctness of the answers to the questionnaire according to education level. Conclusions: many patients do not adequately understand the information provided by healthcare professionals and this could have a negative impact on the incidence of clinical complications.

Perioperative Morbidity and Complications in Patients With an Established Ileostomy Undergoing Major Abdominal Surgery: A Retrospective Study.

Background: Recently formed ileostomies may produce an average of 1,200 ml of watery stool per day, while an established ileostomy output varies between 600–800 ml per day. The reported incidence of renal impartment in patients with ileostomy is 8–20%, which could be caused by dehydration (up to 50%) or high output stoma (up to 40%). There is a lack of evidence if an ileostomy could influence perioperative fluid management and/or surgical outcomes.Methods: Subjects aged ≥18 years old with an established ileostomy scheduled to undergo an elective non-ileostomy-related major abdominal surgery under general anesthesia lasting more than 2 h and requiring hospitalization were included in the study. The primary outcome was to assess the incidence of perioperative complications within 30 days after surgery.Results: A total of 552 potential subjects who underwent non-ileostomy-related abdominal surgery were screened, but only 12 were included in the statistical analysis. In our study cohort, 66.7% of the subjects were men and the median age was 56 years old (interquartile range [IQR] 48-59). The median time from the creation of ileostomy to the qualifying surgery was 17.7 months (IQR: 8.3, 32.6). The most prevalent comorbidities in the study group were psychiatric disorders (58.3%), hypertension (50%), and cardiovascular disease (41.7%). The most predominant surgical approach was open (8 [67%]). The median surgical and anesthesia length was 3.4 h (IQR: 2.5, 5.7) and 4 h (IQR: 3, 6.5), respectively. The median post-anesthesia care unit (PACU) stay was 2 h (IQR:0.9, 3.1), while the median length of hospital stay (LOS) was 5.6 days (IQR: 4.1, 10.6). The overall incidence of postoperative complications was 50% (n = 6). Two subjects (16.7%) had a moderate surgical wound infection, and two subjects (16.7%) experienced a mild surgical wound infection. In addition, one subject (7.6%) developed a major postoperative complication with atrial fibrillation in conjunction with moderate hemorrhage.Conclusions: Our findings suggest that the presence of a well-established ileostomy might not represent a relevant risk factor for significant perioperative complications related to fluid management or hospital readmission. However, the presence of peristomal skin complications could trigger a higher incidence of surgical wound infections.

Hydration by enteroclysis in the distal intestine in patients with a high output stoma: an alternative to parenteral hydration

Rationale: Dehydration is a very common complication of high output jejuno-ileal or ileo-colic double enterostomies, and the most frequent cause of readmissions. Hydration enteroclysis (HE) can be an alternative to parenteral hydration when the downstream intestinal segment is accessible and functional. This work describes our experience with HE in ileal or colonic sites

Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study

BackgroundLittle is known about stoma related morbidity in young children. Therefore, the aim of this study is to assess major morbidity after stoma formation and stoma closure and its associated risk factors. MethodsAll consecutive young children (age ≤ three years) who received a stoma between 1998 and 2018 at our tertiary referral center were retrospectively included. The incidence of major stoma related morbidity (Clavien-Dindo grade ≥III) was the primary outcome. This was separately analysed for stoma formation alone, stoma closure alone and all stoma interventions combined. Non-stoma related morbidity was excluded. Risk factors for major morbidity were identified using multivariable logistic regression analysis. ResultsIn total 336 young children were included with a median follow-up of 6 (IQR:2–11) years. Of these young children, 5% (n = 17/336) received a jejunostomy, 57% (n = 192/336) an ileostomy, and 38% (n = 127/336) a colostomy. Following stoma formation, 27% (n = 92/336) of the young children experienced major stoma related morbidity, mainly consisting of high output stoma, prolapse and stoma stenosis. The major morbidity rate was 23% (n = 66/292) following stoma closure, most commonly comprising anastomotic leakage/stenosis, incisional hernia and adhesive obstructions. For combined stoma interventions, major stoma related morbidity was 39% (n = 130/336). Ileostomy was independently associated with a higher risk of developing major morbidity following stoma formation (OR:2.5; 95%-CI:1.3–4.7) as well as following closure (OR:2.7; 95%-CI:1.3–5.8). ConclusionsMajor stoma related morbidity is a frequent and severe clinical problem in young children, both after stoma formation and closure. The risk of morbidity should be considered when deliberating a stoma.

Case Report: Newborns With Pseudohypoaldosteronism Secondary to Excessive Gastrointestinal Losses Through High Output Stoma

Life-threatening electrolyte imbalance is not uncommon in preemies. Differential diagnosis is important for immediate treatment. The syndrome of pseudohypoaldosteronism (PHA) is characterized by increased aldosterone secretion associated with clinical signs of hypoaldosteronism reflecting mineralocorticoid resistance. There are type I, type II, and secondary type of PHA. Most secondary PHA reported in the pediatric population result from urinary infection and obstructive uropathy and extremely rarely from gastrointestinal fluid loss. Seven preemies accepted jejunostomy or ileostomy, and they suffered from high output stoma. Electrolyte imbalance with bodyweight loss or cardiac event was noted. We found a high level of aldosterone and renin and diagnosed them with secondary PHA due to excessive gastrointestinal losses. After stomal reversal, aldosterone and renin level became normalized, and electrolyte was corrected. This study reports the finding of secondary pseudohyperaldosteronism (hyponatremia, hyperkalemia, and metabolic acidosis) in a series of cases with intestinal resection and ostomy of different causes. Early stomal reversal was recommended.

Adapted ERAS Pathway Versus Standard Care in Patients Undergoing Emergency Surgery for Perforation Peritonitis—a Randomized Controlled Trial

BackgroundEnhanced Recovery After Surgery (ERAS) pathways have an uncertain role in emergencies. To the best of our knowledge, there are no trials studying ERAS in perforation peritonitis across the GI tract, despite it being a common surgical emergency. AimsTo evaluate the safety, feasibility and efficacy of adapted ERAS protocols in emergency laparotomy for perforation peritonitis. MethodsThis was an open-labeled, superiority randomized controlled trial conducted between October 2018 and June 2020 in patients with perforation peritonitis assigned to standard care or adapted ERAS groups using block randomization. Patients with refractory shock, ASA class 4E, localized peritonitis, etc. were excluded. Components of the adapted ERAS protocol included epidural analgesia, goal-directed fluid therapy, avoidance of opioids, early mobilization, early removal of tubes, drains and catheters, and early enteral feeding. The primary outcome, length of hospitalization (LOH), and the secondary outcomes, functional recovery parameters, were analyzed between both the groups. ResultsA total of 59 patients in standard care group and 61 patients in adapted ERAS group were included and randomized, and were comparable in terms of demographic and clinico-pathological characteristics. LOH in adapted ERAS group was shorter by 3 days (p < 0.001), and patients showed reduction in time (days) to first flatus (2.84 vs 4.22, p < 0.001), first stool (4.38 vs 6.08, p < 0.001) and solid diet (4.67 vs 8.37, p < 0.001). Post-operative nausea, vomiting (p = 0.05) and surgical site infections (p < 0.001) were reduced in adapted ERAS group. Pre-existing malignancy, respiratory complications and high output stoma were reasons for delayed discharge in adapted ERAS group. ConclusionAdapted ERAS pathways considerably reduce LOH in patients undergoing emergency surgery for perforation peritonitis, with no adverse events in 30 days after discharge. Trial RegistrationRegistered at http://ctri.nic.in/Clinicaltrials/login.php (CTRI/2019/02/017537).

Personalized exercise intervention in HPN patients - A feasibility study.

Physical health status may be predictive of readmissions, psychological health and mortality in patients with short bowel syndrome. This study aimed to investigate the feasibility and effect of an individualized exercise intervention and secondary, oral nutrition intake counseling on Timed-Up-and-Go (TUG) and 30s Chair Stand Test (CST) as well as body-composition and EuroQol (EQ)-5D-5L, in patients with chronic intestinal failure (IF) type III receiving HPN and/or fluid therapy. A 12-week individualized exercise intervention consisting on three weekly home based sessions, and nutrition counselling focusing on protein intake and reducing high stoma output, was performed. Weekly follow-up by phone was done on motivation to exercise. The study invited 71 patients, 44 accepted the invitation (62%), 37(52%) were included, and 31 (84%) completed the intervention. The exercise intervention was well tolerated. TUG improved from 8.9(SD 5.5) to 7.7(SD 3.8) (p=0.033). CST improved by four repetitions (<0.001∗). A statistical, however not clinically relevant improvement was seen in muscle mass. No improvement was seen in (EQ)-5D-5L total, but insignificantly (p=0.055) for physical function only. Protein intake improved by 10.6g/day (p=0.008). A 12 weeks individualized exercise intervention showed very feasible and beneficial in HPN patients. Physical function improved statistically and clinically, and oral protein intake improved. QoL overall did not improve, however COVID-19 was an uninvited partner throughout the study period, which may have influenced general QoL. As only 62% accepted the invitation to participate, home based exercise intervention may not apply to all patients.

AKT answer relating to high output stomas

AKT answer relating to high output stomas

AKT question relating to high output stomas

AKT question relating to high output stomas

A new palatable oral rehydration solution: A randomised controlled cross-over study in patients with a high output stoma.

Patients with a jejunostomy or high output stoma may need a glucose-sodium oral rehydration solution drink to maintain hydration. These solutions are unpalatable and a new flavoured pre-packaged solution was developed. After 8 h of fasting, 27 patients took 500 mL of the modified World Health Organization (WHO) cholera solution or Glucodrate® (Vitaflo) on two occasions in a cross-over random order and urine and stomal output was collected for 6 h. There was a small but significant difference in net sodium absorption in favour of the modified WHO cholera solution (10 ± 28 mmol modified WHO cholera solution vs. -1 ± 26 mmol Glucodrate®, p = 0.01). However the Glucodrate® was more palatable, with 24 patients (89%) preferring it to the modified WHO cholera solution (p < 0.005). Glucodrate® is a more palatable solution than the modified WHO cholera solution and is almost as effective and so can be used when patients find the modified WHO cholera solution unpalatable.

Impact of a nutrition consultation on the rate of high output stoma-related readmission: an ambispective cohort study

The aims of this study were to assess the impact of a follow-up nutrition consultation for ostomy patients on the rate of high output stoma (HOS)-related readmissions, as well as on the detection of poor nutritional status and their management, and to determine the associated economic impact. A single-centre ambispective cohort study was conducted in which all adult patients undergoing intestinal resection and stoma creation were recruited. Two nutrition consultations were established for early follow-up after hospital discharge and patients were prospectively included. Additionally, a retrospective search was carried out to include a control group. In both groups, a 12-month follow-up was conducted to record readmissions associated with high output stoma. A multivariate logistic regression was performed. Statistical significance level was established at p < 0.05. 170 patients were recruited, 85 patients in each cohort. Demographic data and clinical characteristics were recorded. A significant difference was observed in HOS-related readmissions, with readmission rates of 28.6% vs 10.3% in the retrospective and prospective cohort, respectively. At the first follow-up consultation, 50.5% of patients presented some degree of protein-calorie malnutrition. A statistically significant improvement in nutritional status was observed in the second evaluation. The intervention carried out resulted in a total saving of €24,175. Early follow-up of patients after discharge resulted in a significant reduction in the rate of HOS-related readmissions and allowed to identify a high percentage of patients with malnutrition. The cost analysis showed the process to be a cost-effective improvement.

Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries.

One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS. We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group. A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001). Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.

Readmission after rectal resection in the ERAS-era: is a loop ileostomy the Achilles heel?

BackgroundRectal resection surgery is often followed by a loop ileostomy creation. Despite improvements in surgical technique and development of enhanced recovery after surgery (ERAS) protocols, the readmission-rate after rectal resection is still estimated to be around 30%. The purpose of this study was to identify risk factors for readmission after rectal resection surgery. This study also investigated whether elderly patients (≥ 65 years old) dispose of a distinct patient profile and associated risk factors for readmission.MethodsThis is a retrospective study of prospectively collected data from patients who consecutively underwent rectal resection for cancer within an ERAS protocol between 2011 and 2016. The primary study endpoint was 90-day readmission. Patients with and without readmission within 90 days were compared. Additional subgroup analysis was performed in patients ≥ 65 years old.ResultsA total of 344 patients were included, and 25% (n = 85) were readmitted. Main reasons for readmission were acute renal insufficiency (24%), small bowel obstruction (20%), anastomotic leakage (15%) and high output stoma (11%). In multivariate logistic regression, elevated initial creatinine level (cut-off values: 0.67–1.17 mg/dl) (OR 1.95, p = 0.041) and neoadjuvant radiotherapy (OR 2.63, p = 0.031) were significantly associated with readmission. For ileostomy related problems, elevated initial creatinine level (OR 2.76, p = 0.021) was identified to be significant.ConclusionRecovery after rectal resection within an ERAS protocol is hampered by the presence of a loop ileostomy. ERAS protocols should include stoma education and high output stoma prevention.

Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy.

Background: Ileostomy is often required in patients undergoing bowel resections for inflammatory bowel diseases (IBD), colorectal cancer, and emergencies. Unfortunately, some patients develop a high-output stoma (HOS). This condition affects homeostasis and may be life threatening. We aimed to identify possible risk factors for the development of HOS.Patients and methods: From 2012 to 2018, 296 patients who underwent ileostomy at Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin were retrospectively analyzed. Emergency operations were included. Diverting ileostomy, end ileostomies and anastomotic stomata with at least part ileum, were examined. HOS was defined as stoma output of more than 1,000 mL per day for more than 3 days. Univariate and multivariable analyses were used to detect potential risk factors for the development of HOS.Results: 41 of 296 patients developed HOS (13.9%). Mortality was 0.3%. In the univariate analysis, age (p < 0.002), diagnosis (Crohn's disease, p = 0.005), arterial hypertension (p = 0.023), surgical procedure (right-sided colectomy, small bowel resection, p < 0.001), open technique (p < 0.002), emergencies (p = 0.014), and anastomotic ileostomy (p < 0.001) were identified as risk factors. In the multivariable logistic regression, older age, diagnosis (Crohn's disease) and surgical procedure (right-sided colectomy, separate ileostomy, small bowel resection) remained significant risk factors.Conclusion: The occurrence of HOS is a relevant problem after ileostomy. The identification of risk factors for a high-output may be helpful for monitoring, early diagnosis and initiation of therapy as well as in the planning of close follow-up care.

High incidence of potentially preventable emergency department visits after major elective colorectal surgery.

Emergency department (ED) visits after surgery represent a significant cost burden on the healthcare system. Furthermore, many ED visits are related to issues of healthcare delivery services and may be avoidable. Few studies have assessed the reasons for ED visits after colorectal surgery. The main objectives of this study were to: (1) identify the reasons why patients presented to the ED within 30 postoperative days and (2) determine if these visits were potentially preventable. A retrospective chart review was conducted on elective major colorectal surgery cases performed in a single center between 01/2017 and 07/2019. Data collected included demographics, medical history, intraoperative details, postoperative complications, ED visits within 30 postoperative days, and readmissions. Each ED visit was assessed by two reviewers and graded on a scale adapted from the New York University ED algorithm. The gradings were: (1) non-emergent, (2) emergent but treatable in an ambulatory setting, (3) emergent/ED-care required but preventable if timely outpatient care was available, and (4) emergent/ED-care required and non-preventable. Grades 1-3 were deemed potentially preventable. Logistic regression identified independent predictors of potentially preventable visits. Six hundred and twenty five patients were included in the final analysis. 110 (17.6%) patients presented to the ED within 30days. The most common cause of ED visit were ileus/small bowel obstruction (SBO) (16.4%), superficial wound infection (15.5%), genitourinary issues (10.9%), and non-infectious gastrointestinal issues (nausea, malnutrition, diarrhea, high output stomas) (10.9%). After review, 51.8% of visits were considered potentially preventable (Grade 1-3). The most common causes of preventable ED visits were superficial wound infection (24.6%), non-infectious gastrointestinal issues (19.3%), and minor bleeding (14.0%). Creation of a new stoma was the only independent risk factor for potentially preventable ED visits (OR 2.14, 95%CI 1.03-4.47). Approximately half of ED visits within 30days of discharge were potentially preventable. These findings indicate a need to improve access to outpatient care to reduce preventable ED visits after elective colorectal surgery.

English

BACKGROUND Ileostomy is a lifesaving procedure in cases like perforation, peritonitis, typhoid fever, tuberculosis, and trauma. Ileostomy serves the purpose of diversion, decompression, and exteriorisation. Construction of ileostomy is still a common and frequently performed procedure, even though it is a major advancement in the field of surgery. This study intends to evaluate the clinical profile of ileostomy and assess early postoperative complications of ileostomy. METHODS A total number of 36 patients admitted in MMIMSR, Mullana (Ambala), managed and operated with ileostomy were followed up closely from the day of admission in the hospital to the day of discharge. Different parameters were studied. RESULTS The clinical profile, techniques, complications, indications of ileostomy were studied in detail and along with various early complications encountered with ileostomy formation. The most common complication was peristomal irritation in 33 patients (91.7 %), followed by skin excoriation in 24 patients (66.7 %), fistula in 21 patients (58.3 %), high output stoma in 17 patients (47.2 %), stomal retraction in 3 patients (8.3 %), abscess in 2 patients (5.6 %), necrosis in 1 patient (2.8 %), and stenosis in 1 patient (2.8 %). CONCLUSIONS Construction of ileostomy and its management was associated with high rate of complications. However, most patients tolerated the complications of ileostomy well and the overall compliance was satisfactory. Loop ileostomy was the most commonly performed stoma and was associated with high rate of complications. KEY WORDS Intestinal Stoma, Complications, Loop Ileostomy, End Ileostomy, Skin Excoriation, Fistula, High Output Ileostomy

Risk factors for peristomal skin disorders associated with temporary ileostomy construction.

Skin disorders are the most common stoma-related complications after temporary diverting loop ileostomy with proctectomy. The aim of the present study was to investigate risk factors for skin disorders associated with temporary ileostomy construction. A total of 185 consecutive patients who underwent curative proctectomy with temporary diverting loop ileostomy for rectal malignancies at a single comprehensive cancer center between 2013 and 2018 were collected and analyzed. The most frequent stoma-related complications were skin disorders (n = 62, 33.5%), followed by mucocutaneous separation (n = 38, 20.5%) and high-output stoma (n = 34, 18.4%). Patients with skin disorders had a higher median body mass index (BMI; 22.4 vs. 21.3kg/m2, P = 0.002) and lower stoma height (16 vs. 20mm, P < 0.001) than those without skin disorders. According to a multivariable logistic regression analysis, independent predictors of skin disorders included overweight (median BMI ≥ 25kg/m2 [odds ratio = 3.6, 95% confidence interval: 1.5-8.6], P = 0.004) and lower stomal height (median stoma height < 20mm [odds ratio = 3.2, 95% confidence interval: 1.6-6.3], P < 0.001). Overweight and lower stoma height are correlated with the presence of skin disorders. Construction of a well-elevated stoma can reduce skin disorders associated with temporary ileostomy construction.