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Risk Factors for Postoperative Complications Following Diverting Loop Ileostomy Takedown

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Introduction

Diverting loop ileostomies are frequently created to divert the fecal stream in an effort to protect downstream anastomoses. These are later reversed to restore intestinal continuity. The goal of this study is to evaluate risk factors for postoperative complications following diverting loop ileostomy takedown.

Materials and Methods

Patients who underwent diverting loop ileostomy takedown between January 1, 2010 and April 28, 2015 were identified in the Michigan Surgical Quality Collaborative registry. Candidate covariates were identified and a hierarchical logistic regression model was used to identify risk factors for postoperative complications.

Results

1,737 patients met the inclusion criteria. Rates of postoperative complications were generally low. Mean length of stay (LOS) was 5.6 (± 4.5) days. Outcomes of interest were the following: overall morbidity, serious morbidity, extended LOS, SSI, UTI, pneumonia, readmission, reoperation, and mortality. Risk factors for these outcomes included the following: ASA class, bleeding disorder, prolonged operative time, race, tobacco use, gender, steroid use, peripheral vascular disease, weight loss, and functional status.

Conclusions

Diverting loop ileostomy takedown has a complication rate of approximately 20%. Higher ASA class, longer operative times, history of bleeding disorder, and functional status were identified as risk factors for most complications.

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Funding

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, St. Joseph Mercy Health System – Ann Arbor, Ann Arbor, MI, 48106, USA

    Anuradha R. Bhama, Farwa Batool, Jane Ferraro & Robert K. Cleary

  2. Michigan Surgical Quality Collaborative, University of Michigan, Ann Arbor, MI, 48104, USA

    Stacey D. Collins

Authors
  1. Anuradha R. Bhama
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  2. Farwa Batool
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  3. Stacey D. Collins
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  4. Jane Ferraro
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  5. Robert K. Cleary
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Corresponding author

Correspondence to Anuradha R. Bhama.

Ethics declarations

The St. Joseph Mercy Health System Institutional Review Board approval was obtained for this study.

Additional information

Previous Communication: Presented as a podium presentation at the American Society of Colon and Rectal Surgeons Annual Scientific Meeting, April 30 – May 4, 2016, Los Angeles, California

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Bhama, A.R., Batool, F., Collins, S.D. et al. Risk Factors for Postoperative Complications Following Diverting Loop Ileostomy Takedown. J Gastrointest Surg 21, 2048–2055 (2017). https://doi.org/10.1007/s11605-017-3567-y

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  • DOI: https://doi.org/10.1007/s11605-017-3567-y

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