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Analysis of Outcomes by Extraction Site following Subtotal Colectomy in Ulcerative Colitis: A Retrospective Cohort Study

  • 2018 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Ulcerative colitis frequently requires surgery as a definitive management strategy. The colonic specimen can be extracted from various sites including a midline incision, the stoma site, or a Pfannenstiel incision. It is unclear if one extraction site offers improved outcomes and fewer complications.

Methods

A retrospective review of charts obtained of colorectal surgery patients was conducted for all patients with ulcerative colitis who underwent a subtotal colectomy between 2008 and 2016 at a single tertiary care institution. Demographic data and outcomes data including parastomal and incisional hernias, advanced wound/ostomy certified nurse referrals, surgical site infections, reoperations, and readmissions were collected. Univariate and multivariate analyses were completed to detect any significant differences in outcomes between groups based on extraction site (midline incision, stoma site, or Pfannenstiel incision).

Results

Univariate analysis did not show any statistical differences between groups in regard to outcomes. Stoma site extraction did not statistically differ from midline extraction in regard to hernias, advanced ostomy referrals, infections, or reoperations, but midline incision extraction did have a lower risk of readmission (OR = 0.56, p = 0.0066). Pfannenstiel extraction had lower risk of incisional hernias (OR = 0.25, p = 0.0002), advanced ostomy referrals (OR = 0.45, p = 0.0164) and readmission (OR = 0.26, p < 0.0001) as compared to stoma site extraction.

Conclusions

While stoma site extraction can be successfully performed for most patients requiring subtotal colectomy for ulcerative colitis, Pfannenstiel extraction leads to the fewest number of complications and provides the most consistent results.

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Authors and Affiliations

  1. Department of Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 15th Floor, Box 1259, New York, NY, 10029, USA

    Christopher R. LaChapelle, Stewart Whitney, Michael Plietz, Marina Reppucci & Songhon Hwang

  2. Tufts University School of Medicine, Boston, MA, 02111, USA

    Jeffrey Aalberg

  3. Department of Obstetrics and Gynecology, Rush University Medical Center, Deerfield, IL, 60015, USA

    Allison Salk

  4. The Moses Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 15th Floor, Box 1259, New York, NY, 10029, USA

    Sergey Khaitov & Alexander J. Greenstein

Authors
  1. Christopher R. LaChapelle
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  2. Stewart Whitney
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  3. Jeffrey Aalberg
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  4. Michael Plietz
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  5. Marina Reppucci
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  6. Allison Salk
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  7. Songhon Hwang
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  8. Sergey Khaitov
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  9. Alexander J. Greenstein
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Contributions

All authors (LaChapelle, Whitney, Aalberg, Plietz, Reppucci, Salk, Hwang, Khaitov, and Greenstein) have made substantial contributions to the conception/design of the work; or the acquisition, analysis, or interpretation of data for the work; AND drafting the work or revising it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Christopher R. LaChapelle.

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The authors declare that they have no conflict of interest.

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LaChapelle, C.R., Whitney, S., Aalberg, J. et al. Analysis of Outcomes by Extraction Site following Subtotal Colectomy in Ulcerative Colitis: A Retrospective Cohort Study. J Gastrointest Surg 24, 933–938 (2020). https://doi.org/10.1007/s11605-019-04481-w

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  • DOI: https://doi.org/10.1007/s11605-019-04481-w

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