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01-04-2020 | Ulcerative Colitis | 2018 SSAT Poster Presentation

Analysis of Outcomes by Extraction Site following Subtotal Colectomy in Ulcerative Colitis: A Retrospective Cohort Study

Authors: Christopher R. LaChapelle, Stewart Whitney, Jeffrey Aalberg, Michael Plietz, Marina Reppucci, Allison Salk, Songhon Hwang, Sergey Khaitov, Alexander J. Greenstein

Published in: Journal of Gastrointestinal Surgery | Issue 4/2020

Abstract

Background

Ulcerative colitis frequently requires surgery as a definitive management strategy. The colonic specimen can be extracted from various sites including a midline incision, the stoma site, or a Pfannenstiel incision. It is unclear if one extraction site offers improved outcomes and fewer complications.

Methods

A retrospective review of charts obtained of colorectal surgery patients was conducted for all patients with ulcerative colitis who underwent a subtotal colectomy between 2008 and 2016 at a single tertiary care institution. Demographic data and outcomes data including parastomal and incisional hernias, advanced wound/ostomy certified nurse referrals, surgical site infections, reoperations, and readmissions were collected. Univariate and multivariate analyses were completed to detect any significant differences in outcomes between groups based on extraction site (midline incision, stoma site, or Pfannenstiel incision).

Results

Univariate analysis did not show any statistical differences between groups in regard to outcomes. Stoma site extraction did not statistically differ from midline extraction in regard to hernias, advanced ostomy referrals, infections, or reoperations, but midline incision extraction did have a lower risk of readmission (OR = 0.56, p = 0.0066). Pfannenstiel extraction had lower risk of incisional hernias (OR = 0.25, p = 0.0002), advanced ostomy referrals (OR = 0.45, p = 0.0164) and readmission (OR = 0.26, p < 0.0001) as compared to stoma site extraction.

Conclusions

While stoma site extraction can be successfully performed for most patients requiring subtotal colectomy for ulcerative colitis, Pfannenstiel extraction leads to the fewest number of complications and provides the most consistent results.

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Title: Analysis of Outcomes by Extraction Site following Subtotal Colectomy in Ulcerative Colitis: A Retrospective Cohort Study
Authors: Christopher R. LaChapelle
Stewart Whitney
Jeffrey Aalberg
Michael Plietz
Marina Reppucci
Allison Salk
Songhon Hwang
Sergey Khaitov
Alexander J. Greenstein
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Ulcerative Colitis
Enterostomy
Colectomy
Subtotal Colectomy
Colectomy
Incision
Enterostomy
Subtotal Colectomy
Incisional Hernia
Parastomale Hernie
Published in: Journal of Gastrointestinal Surgery / Issue 4/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04481-w

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Analysis of Outcomes by Extraction Site following Subtotal Colectomy in Ulcerative Colitis: A Retrospective Cohort Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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