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

doi:10.3393/ac.2021.00241.0034

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저자정보: Assaf Dan (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center) Hazzan David (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center) Ben-Yaacov Almog (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center) Laks Shachar (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center) Zippel Douglas (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center) Segev Lior (Department of General and Oncological Surgery–Surgery C The Chaim Sheba Medical Center)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.39 No.2

발행연도: 2023.4

수록면: 168 - 174 (7page)

DOI: 10.3393/ac.2021.00241.0034

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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.

#Ileostomy #Patient readmission #Dehydration

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