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Journey for patients following ileostomy creation is not straightforward

  • Dedrick Kok Hong Chan
  • Jingyu Ng
  • Frederick Hong-Xiang Koh
  • Tianzhi Lim
  • Danson Yeo
  • Kok-Yang Tan
  • Ker-Kan TanEmail author
Original Article
  • 25 Downloads

Abstract

Background

An ileostomy is usually created to avert systemic sepsis in a patient with a tenuous anastomosis. However, what is often not reported are the numerous issues facing these patients subsequently, ranging from readmissions, non-reversal of the stoma, and complications from the closure. This study was performed to identify these issues among patients following creation of an ileostomy.

Methods

We conducted a retrospective analysis of consecutive patients who had an ileostomy created from January 2011 to December 2016 at two institutions. Statistical analysis was performed to identify risk factors associated with readmissions and ileostomy non-reversal.

Results

In total, 193 patients had an ileostomy created during the study period. Twenty-six (13.5%) patients developed stoma-related complications requiring readmission. The most common cause of readmission (9.3%) was due to dehydration and acute kidney injury secondary to high stoma output. One hundred thirty (67.4%) patients had their ileostomy reversed. On multivariate analysis, only stomas created during an ultra-low anterior resection were associated with reversal (OR 2.88 [95% CI, 1.24–6.68]; p = 0.014). Among the patients who underwent ileostomy reversal, seven (3.6%) patients developed complications from their ileostomy reversal. Four patients (2.1%) suffered from an anastomotic leak which required repeat surgical intervention with one mortality from the ensuing sepsis.

Conclusion

Almost half of the patients who had an Ileostomy had an undesirable outcome, including readmissions, non-reversal, and post-operative complications following closure. Patients need to be properly counselled about the risks involved prior to the index operation.

Keywords

Ileostomy Complications Reversal 

Notes

Compliance with ethical standards

Institutional Review Board (IRB) ethics approval was obtained for this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Colorectal Surgery, University Surgical ClusterNational University Health SystemSingaporeSingapore
  2. 2.Department of Surgery, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  3. 3.Division of Colorectal Surgery, Ng Teng Fong General HospitalNational University Health SystemSingaporeSingapore
  4. 4.Department of SurgeryKhoo Teck Puat HospitalSingaporeSingapore

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