Huang YL, Gao YY, Zhang J, Wang L, Wu AW. Attitudes and technical maneuvers regarding enterostomy management and stoma creation among surgeons: A cross-sectional study. World J Gastrointest Surg 2026; 18(6): 118883 [DOI: 10.4240/wjgs.118883]
Corresponding Author of This Article
Ai-Wen Wu, MD, PhD, Chief, Professor, State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. drwuaw@sina.cn
Research Domain of This Article
Surgery
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2026; 18(6): 118883 Published online Jun 27, 2026. doi: 10.4240/wjgs.118883
Attitudes and technical maneuvers regarding enterostomy management and stoma creation among surgeons: A cross-sectional study
Yong-Lin Huang, Yu-Ye Gao, Jie Zhang, Lin Wang, Ai-Wen Wu
Yong-Lin Huang, Yu-Ye Gao, Jie Zhang, Lin Wang, State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Gastrointestinal Center, Unit III, Peking University Cancer Hospital and Institute, Beijing 100142, China
Ai-Wen Wu, State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital, Beijing 100142, China
Co-first authors: Yong-Lin Huang and Yu-Ye Gao.
Author contributions: Huang YL designed and conducted the study and wrote the manuscript; Gao YY contributed to data analysis; Zhang J and Wang L provided clinical advice; Wu AW supervised the study; and all authors have read and approved the final manuscript.
Supported by the National Key Research and Development Program of China, No. 2021YFF1201104; National Natural Science Foundation of China, No. 82173156; and Beijing Hospitals Authority Clinical Medicine Development of Special Funding, No. ZYLX202116.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Peking University Cancer Hospital and Institute, approval No. 2024KT112.
Informed consent statement: This study involved a survey of healthcare professionals and did not include any patient data or identifiable information.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The original anonymous datasets are available from the corresponding authors on reasonable request.
Corresponding author: Ai-Wen Wu, MD, PhD, Chief, Professor, State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. drwuaw@sina.cn
Received: January 15, 2026 Revised: February 1, 2026 Accepted: April 3, 2026 Published online: June 27, 2026 Processing time: 151 Days and 21.7 Hours
Abstract
BACKGROUND
Enterostomy is a routine procedure in colorectal surgery; however, stoma-related complications remain substantial. Variations in surgical performance, limited formal training, and insufficient collaboration between surgeons and enterostomal therapists contribute to inconsistent enterostomy management. Nevertheless, surgeons’ attitudes and technical practices toward stoma creation remain poorly characterized.
AIM
To characterize Chinese surgeons’ attitudes toward enterostomy and to describe their technical preferences in stoma creation.
METHODS
Through a comprehensive literature review, pilot testing, and expert consultation, a 37-item self-administered electronic questionnaire was developed. The survey was distributed through professional surgical networks and collaborative groups between June and July 2022, and eligible surgeons participated voluntarily. Following ethical approval in 2024, the data were retrospectively curated and analyzed. Descriptive analyses and subgroup comparisons were performed using the χ2 test, Fisher’s exact test, or Cramér’s V.
RESULTS
A total of 417 responses were received, and 16 duplicate questionnaires from the pilot phase were excluded. Among the 401 surgeons included, 60.4% reported having received formal training in stoma creation. Although 99.5% considered stoma-related complications to be related to surgical techniques, only 56.1% had participated in dedicated discussions or formal training programs. 37.2% reported that the adoption rate of preoperative stoma site marking was below 60%, and 44.6% considered the site selection performed by enterostomal therapists to be inaccurate. Substantial variability was observed in preoperative stoma site marking preferences and technical maneuvers during stoma creation, with no single approach predominant. No significant differences in self-reported attitudes toward enterostomy were observed between the junior and senior surgeons. Surgeons from secondary and lower-tier hospitals appeared to have less exposure to theoretical and practical training than those from tertiary hospitals.
CONCLUSION
Chinese surgeons demonstrate marked variability in the attitudes, concepts, and technical maneuvers in enterostomy creation. This heterogeneity may contribute to inconsistent clinical practices and variable patient outcomes. Future studies should focus on developing and validating a standardized training curriculum for enterostomy creation.
Core Tip: This nationwide, surgeon-centered survey provides a comprehensive overview of current attitudes, training backgrounds, and technical practices related to enterostomy management in China. The findings reveal substantial heterogeneity in surgical concepts and operative maneuvers, insufficient formal training, and suboptimal collaboration between surgeons and enterostomal therapists. By systematically mapping real-world practices across institutions and surgeon grades, this study highlights critical gaps in standardization and underscores the need for patient-centered, multidisciplinary training programs to improve enterostomy quality and reduce stoma-related complications.
