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Surgery Today
Published in: Surgery Today 3/2021

01-03-2021 | Rectal Cancer | Original Article

Risk factors for outlet obstruction after laparoscopic surgery and diverting ileostomy for rectal cancer

Authors: Shigemasa Sasaki, Toshiya Nagasaki, Koji Oba, Takashi Akiyoshi, Toshiki Mukai, Tomohiro Yamaguchi, Yosuke Fukunaga, Yoshiya Fujimoto

Published in: Surgery Today | Issue 3/2021

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Abstract

Purpose

Outlet obstruction is defined as bowel obstruction at the stoma opening. The aim of this study was to evaluate the risk factors for outlet obstruction in patients with rectal cancer who underwent laparoscopic surgery and diverting ileostomy.

Methods

Among consecutive patients who underwent laparoscopic curative resection for primary rectal cancer between 2013 and 2015, 261 patients with diverting ileostomy were included in the analysis. The thickness of the abdominal wall, including the thickness of the rectus abdominis muscle, was measured using preoperative computed tomography. The clinicopathological factors were compared between the patients with and without outlet obstruction.

Results

Fourteen (5.4%) patients were diagnosed with outlet obstruction, but reoperation was not required. The rectus abdominis muscle was significantly thicker in male patients with outlet obstruction compared to those without outlet obstruction, but not in females. In a multivariate analysis, a rectus abdominis muscle thickness of 10 mm or more was determined to be an independent risk factor for outlet obstruction (odds ratio, 7.0482; p = 0.0061).

Conclusions

The thickness of the rectus abdominis muscle may be used to predict the occurrence of outlet obstruction in male patients with rectal cancer who undergo laparoscopic surgery and diverting ileostomy.
Appendix
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Metadata
Title
Risk factors for outlet obstruction after laparoscopic surgery and diverting ileostomy for rectal cancer
Authors
Shigemasa Sasaki
Toshiya Nagasaki
Koji Oba
Takashi Akiyoshi
Toshiki Mukai
Tomohiro Yamaguchi
Yosuke Fukunaga
Yoshiya Fujimoto
Publication date
01-03-2021
Publisher
Springer Singapore
Published in
Surgery Today / Issue 3/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02096-2

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