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Surgery Today
Published in: Surgery Today 12/2018

01-12-2018 | Original Article

Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study

Authors: Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa

Published in: Surgery Today | Issue 12/2018

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Abstract

Purpose

Stoma outlet obstruction (SOO) is a complication following colorectal surgery that requires stoma creation. We aimed to clarify the SOO incidence and identify risk factors for SOO after stoma surgery in patients with ulcerative colitis (UC) or rectal cancer.

Methods

The study included 345 patients with sporadic rectal cancer (n = 301) or UC (n = 44) who underwent stoma surgery between 2012 and 2017. Univariate and multivariate analyses were performed to identify risk factors for SOO.

Results

The SOO incidences were 27.3% (n = 12) in patients with UC and 5.6% (n = 17) in patients with sporadic rectal cancer. A multivariate analysis identified UC and loop ileostomy as independent risk factors for SOO. Subanalyses revealed that loop ileostomy was an independent risk factor for patients with UC or sporadic rectal cancer. Most patients who developed SOO were successfully managed with tube drainage through the stoma. However, stoma closure was performed earlier than originally planned in two patients. Among the 29 patients with SOO, 22 (75.9%) developed SOO within 2 weeks postoperatively; the median period between stoma creation and SOO was 6 (range 3–41) days.

Conclusions

UC and loop ileostomy are independent risk factors for postoperative SOO.
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Metadata
Title
Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
Authors
Satoshi Okada
Keisuke Hata
Shigenobu Emoto
Koji Murono
Manabu Kaneko
Kazuhito Sasaki
Kensuke Otani
Takeshi Nishikawa
Toshiaki Tanaka
Kazushige Kawai
Hiroaki Nozawa
Publication date
01-12-2018
Publisher
Springer Singapore
Published in
Surgery Today / Issue 12/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1698-8

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