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To analyze the risk factors that influence the occurrence of complications in patients with an end colostomy in a long-termprospective study of patients with colorectal disease.Prospective follow-up of cohort of 556 consecutive patients undergoing end colostomy for colorectal disease between May 1990 and March 2009. Patients were identified and monitored by the stomatherapy unit. We performed univariate and multivariate statistical analysis.The mean age was 70 years (I QR 38-72), with aslight femalepredominance (51.4%). The mean follow-up time was 42 months (IQR 10-120). Colorectal neoplasia was the most frequent indication (73.6%). 29.3% of patients had one or more stoma-related complication. The most frequent complications were retraction (9.4%), parastomal hernia (7.9%) and dermatitis (3.6%). Obesity was a significant riskfactor for complications (P = 0.004, OR 1.9, CI 1.2-2.9). Previous assessment by a stomatherapy nurse and construction of the stoma by a colorectal surgeon were not associated with an increased rate of complications (P = 0.014, OR 1.6, CI 1.12-2.37; P = 0.003, OR 0.4, CI 0.2-0.7 respectively).Construction of an end colostomy is a complexprocedure. In our long-term follow-up it was found that obesity, not the involvement of a colorectal surgeon orpre-operative counselling, was associated with a higher rate of stoma complications.