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Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries.
Assaf, Dan; Hazzan, David; Ben-Yaacov, Almog; Laks, Shachar; Zippel, Douglas; Segev, Lior.
Afiliación
  • Assaf D; Department of General and Oncological Surgery-Surgery C, The Chaim Sheba Medical Center, Ramat Gan, Israel.
  • Hazzan D; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Ben-Yaacov A; Department of General and Oncological Surgery-Surgery C, The Chaim Sheba Medical Center, Ramat Gan, Israel.
  • Laks S; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Zippel D; Department of General and Oncological Surgery-Surgery C, The Chaim Sheba Medical Center, Ramat Gan, Israel.
  • Segev L; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ann Coloproctol ; 39(2): 168-174, 2023 Apr.
Article en En | MEDLINE | ID: mdl-34364318
ABSTRACT

PURPOSE:

One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS.

METHODS:

We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group.

RESULTS:

A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001).

CONCLUSION:

Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.
Palabras clave

Texto completo: 1 Colección: 01-internacional Tipo de estudio: Prognostic_studies Idioma: En Revista: Ann Coloproctol Año: 2023 Tipo del documento: Article País de afiliación: Israel

Texto completo: 1 Colección: 01-internacional Tipo de estudio: Prognostic_studies Idioma: En Revista: Ann Coloproctol Año: 2023 Tipo del documento: Article País de afiliación: Israel