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Journey for patients following ileostomy creation is not straightforward

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International Journal of Colorectal Disease Aims and scope Submit manuscript

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.

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References

  1. Lightner AL, Pemberton JH (2017) The role of temporary fecal diversion. Clin Colon Rectal Surg 30(3):178–183

    Article  Google Scholar 

  2. Li L, Lau KS, Ramanathan V, Orcutt ST, Sansgiry S, Albo D, Berger DH, Anaya DA (2017) Ileostomy creation in colorectal cancer surgery: risk of acute kidney injury and chronic kidney disease. J Surg Res 210:204–212

    Article  Google Scholar 

  3. Löb S, Luetkens K, Krajinovic K, Wiegering A, Germer CT, Seyfried F (2018) Impact of surgical proficiency levels on postoperative morbidity: a single centre analysis of 558 ileostomy reversals. Int J Color Dis 33(5):601–608

    Article  Google Scholar 

  4. Yilmaz E, Çelebi D, Kaya Y, Baydur H (2017) A descriptive, cross-sectional study to assess quality of life and sexuality in Turkish patients with a colostomy. Ostomy Wound Manage 63(8):22–29

    Article  Google Scholar 

  5. Gastinger I, Marusch F, Steinert R, Wolff S, Koeckerling F, Lippert H, Working Group ‘Colon/Rectum Carcinoma’ (2005) Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg 92(9):1137–1142

    Article  CAS  Google Scholar 

  6. Paquette IM, Solan P, Rafferty JF, Ferguson MA, Davis BR (2013) Readmission for dehydration or renal failure after ileostomy creation. Dis Colon Rectum 56(8):974–979

    Article  Google Scholar 

  7. Messaris E, Sehgal R, Deiling S, Koltun WA, Stewart D, McKenna K, Poritz LS (2012) Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum 55(2):175–180

    Article  Google Scholar 

  8. Li W, Stocchi L, Cherla D, Liu G, Agostinelli A, Delaney CP, Steele SR, Gorgun E (2017) Factors associated with hospital readmission following diverting ileostomy creation. Tech Coloproctol 21(8):641–648

    Article  CAS  Google Scholar 

  9. Gunnells DJ Jr, Wood LN, Goss L, Morris MS, Kennedy GD, Cannon JA, Chu DI (2018) Racial disparities after stoma construction exist in time to closure after 1 year but not in overall stoma reversal rates. J Gastrointest Surg 22(2):250–258

    Article  Google Scholar 

  10. Chow A, Tilney HS, Paraskeva P, Jeyarajah S, Zacharakis E, Purkayastha S (2009) The morbidity surrounding reversal of defunctioning ileostomies: a systematic review of 48 studies including 6,107 cases. Int J Color Dis 24(6):711–723

    Article  Google Scholar 

  11. Bhama AR, Batool F, Collins SD, Ferraro J, Cleary RK (2017) Risk factors for postoperative complications following diverting loop ileostomy takedown. J Gastrointest Surg 21(12):2048–2055

    Article  Google Scholar 

  12. Luglio G, Pendlimari R, Holubar SD, Cima RR, Nelson H (2011) Loop ileostomy reversal after colon and rectal surgery: a single institutional 5-year experience in 944 patients. Arch Surg 146(10):1191–1196

    Article  Google Scholar 

  13. Faunø L, Rasmussen C, Sloth KK, Sloth AM, Tøttrup A (2012) Low complication rate after stoma closure. Consultants attended 90% of the operations. Color Dis 14(8):e499–e505

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Colorectal Surgery, University Surgical Cluster, National University Health System, System, 1E Kent Ridge Road, Singapore, 119228, Singapore

    Dedrick Kok Hong Chan, Frederick Hong-Xiang Koh, Tianzhi Lim & Ker-Kan Tan

  2. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore, Singapore

    Dedrick Kok Hong Chan & Ker-Kan Tan

  3. Division of Colorectal Surgery, Ng Teng Fong General Hospital, National University Health System, 1E Kent Ridge Rd, Singapore, Singapore

    Jingyu Ng

  4. Department of Surgery, Khoo Teck Puat Hospital, 1E Kent Ridge Rd, Singapore, Singapore

    Danson Yeo & Kok-Yang Tan

Authors
  1. Dedrick Kok Hong Chan
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  2. Jingyu Ng
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  3. Frederick Hong-Xiang Koh
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  4. Tianzhi Lim
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  5. Danson Yeo
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  7. Ker-Kan Tan
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Correspondence to Ker-Kan Tan.

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

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Chan, D.K.H., Ng, J., Koh, F.HX. et al. Journey for patients following ileostomy creation is not straightforward. Int J Colorectal Dis 34, 2075–2080 (2019). https://doi.org/10.1007/s00384-019-03428-6

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  • DOI: https://doi.org/10.1007/s00384-019-03428-6

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