Background: Stoma surgery remains a fundamental component of surgical management for severe digestive diseases, particularly colorectal cancers, intestinal obstructions, traumatic injuries, and advanced esophageal malignancies. In sub-Saharan Africa, and specifically in Cameroon, data regarding their epidemiology, indications, complications, and outcomes are scarce. This study aimed to comprehensively characterize ostomy procedures, analyze their indications, and identify factors associated with postoperative complications and mortality in a multicenter Cameroonian setting.

Methods: A multicenter retrospective study was conducted in four tertiary referral hospitals in Douala, Cameroon, over a nine-year period (January 2015–December 2024). Sociodemographic, clinical, surgical, and postoperative data were extracted from patient records. Descriptive statistics were performed, followed by bivariate analyses using Chi-square or Fisher’s exact tests. Crude odds ratios (OR) with 95% confidence intervals (CI) were calculated to identify factors associated with postoperative complications and mortality.

Results: A total of 180 complete medical records were analyzed. The mean age was 46.6 ± 16.2 years, with a male predominance (61.1%). Colostomies were the most frequent stomas (59.5%), predominantly sigmoid colostomies (38.9%). The main indications were colorectal cancer (20.8%), intestinal obstruction (15.4%), and esophageal cancer (14.8%). Postoperative complications occurred in 27.8% of patients. Ileostomy was significantly associated with postoperative complications (OR = 2.3; 95% CI [1.1–4.9]; p = 0.03), as were oncological indications (OR = 1.9; 95% CI [1.0–3.6]; p = 0.04). Mortality (5%) was significantly associated with advanced malignancy (OR = 3.1; p = 0.02) and severe postoperative complications (OR = 4.5; p = 0.01).

Conclusion: Digestive stomas are indispensable in the management of severe digestive diseases in Cameroon. However, complication rates remain high, particularly among patients with ileostomies and oncological indications. Strengthening perioperative optimization, postoperative monitoring, and structured stoma care programs is crucial to improving outcomes in resource-limited settings.