Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure
<i>Background and Objectives</i>: The aim of this study was to assess any predisposing factors to the morbidity of fashioning and reversal of diverting ileostomy in a prospective cohort of patients who have undergone TME and low colo-rectal or colo-anal anastomosis for rectal cancer. <...
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MDPI AG
2024-11-01
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| Online Access: | https://www.mdpi.com/1648-9144/60/11/1864 |
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| author | Nikolaos Gouvas Dimitrios Manatakis Christos Agalianos Nikoletta Dimitriou Ioannis Baloyiannis George Tzovaras Evangelos Xynos |
| author_facet | Nikolaos Gouvas Dimitrios Manatakis Christos Agalianos Nikoletta Dimitriou Ioannis Baloyiannis George Tzovaras Evangelos Xynos |
| author_sort | Nikolaos Gouvas |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The aim of this study was to assess any predisposing factors to the morbidity of fashioning and reversal of diverting ileostomy in a prospective cohort of patients who have undergone TME and low colo-rectal or colo-anal anastomosis for rectal cancer. <i>Materials and Methods:</i> Consecutive patients with rectal cancer undergoing low anterior resection and a defunctioning loop ileostomy in three surgical units from 2016 to 2020 were included in the study and retrospectively analyzed. <i>Results</i>: One hundred eighty-two patients from three centres were included. Ileostomy-related mortality was 0.5%, attributed to renal failure.. Ileostomy-related morbidity was 46%. Postoperative ileus was seen in 37.4%, and dehydration in 18.8% of the patients. The readmission rate for ileostomy-related reasons was 15.4%. Stoma care was problematic in 15.7% or poor in 7% of the cases. Advanced age, male gender and obesity were independent risk factors for ileostomy-related morbidity. Ileostomy was reversed in 165 patients. The morbidity in 165 patients was 16%. Ileus was seen in 10.3%, anastomotic leak in 4.8% and wound infection in 12.7% of the cases. One patient died because of an anastomotic leak. No predisposing factors that affect the outcomes of ileostomy closure were identified. <i>Conclusions</i>: Diverting ileostomy-related morbidity is high. Life threatening dehydration and renal failure from ileus is more commonly seen in elderly, male and obese patients and should be anticipated. Ileostomy closure-related morbidity is low. |
| format | Article |
| id | doaj-art-7b918f3a78d94a22b3e1fb769901fdf6 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-7b918f3a78d94a22b3e1fb769901fdf62024-11-26T18:12:43ZengMDPI AGMedicina1010-660X1648-91442024-11-016011186410.3390/medicina60111864Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and ClosureNikolaos Gouvas0Dimitrios Manatakis1Christos Agalianos2Nikoletta Dimitriou3Ioannis Baloyiannis4George Tzovaras5Evangelos Xynos6Department of General Surgery, Medical School, University of Cyprus, Nicosia 2404, CyprusDepartment of General Surgery, Naval & Veterans Hospital, 11521 Athens, GreeceDepartment of General Surgery, Naval & Veterans Hospital, 73200 Chania, GreeceDepartment of General Surgery, Medical School, University of Cyprus, Nicosia 2404, CyprusDepartment of General Surgery, University Hospital of Larissa, 41334 Larisa, GreeceDepartment of General Surgery, University Hospital of Larissa, 41334 Larisa, GreeceDepartment of General Surgery, Creta Interclinic Hospital, 71304 Heraklion, Greece<i>Background and Objectives</i>: The aim of this study was to assess any predisposing factors to the morbidity of fashioning and reversal of diverting ileostomy in a prospective cohort of patients who have undergone TME and low colo-rectal or colo-anal anastomosis for rectal cancer. <i>Materials and Methods:</i> Consecutive patients with rectal cancer undergoing low anterior resection and a defunctioning loop ileostomy in three surgical units from 2016 to 2020 were included in the study and retrospectively analyzed. <i>Results</i>: One hundred eighty-two patients from three centres were included. Ileostomy-related mortality was 0.5%, attributed to renal failure.. Ileostomy-related morbidity was 46%. Postoperative ileus was seen in 37.4%, and dehydration in 18.8% of the patients. The readmission rate for ileostomy-related reasons was 15.4%. Stoma care was problematic in 15.7% or poor in 7% of the cases. Advanced age, male gender and obesity were independent risk factors for ileostomy-related morbidity. Ileostomy was reversed in 165 patients. The morbidity in 165 patients was 16%. Ileus was seen in 10.3%, anastomotic leak in 4.8% and wound infection in 12.7% of the cases. One patient died because of an anastomotic leak. No predisposing factors that affect the outcomes of ileostomy closure were identified. <i>Conclusions</i>: Diverting ileostomy-related morbidity is high. Life threatening dehydration and renal failure from ileus is more commonly seen in elderly, male and obese patients and should be anticipated. Ileostomy closure-related morbidity is low.https://www.mdpi.com/1648-9144/60/11/1864defunctioning ileostomyrectal cancermorbidityileostomy reversal |
| spellingShingle | Nikolaos Gouvas Dimitrios Manatakis Christos Agalianos Nikoletta Dimitriou Ioannis Baloyiannis George Tzovaras Evangelos Xynos Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure Medicina defunctioning ileostomy rectal cancer morbidity ileostomy reversal |
| title | Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure |
| title_full | Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure |
| title_fullStr | Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure |
| title_full_unstemmed | Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure |
| title_short | Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure |
| title_sort | defunctioning ileostomy after low anterior resection of rectum morbidity related to fashioning and closure |
| topic | defunctioning ileostomy rectal cancer morbidity ileostomy reversal |
| url | https://www.mdpi.com/1648-9144/60/11/1864 |
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