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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 10/2013

01-10-2013 | Original Article

The nutritional impact of diverting stoma-related complications in elderly rectal cancer patients

Authors: Bong-Hyeon Kye, Hyung-Jin Kim, Jun-Gi Kim, Hyeon-Min Cho

Published in: International Journal of Colorectal Disease | Issue 10/2013

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Abstract

Purpose

Diverting stomas following rectal cancer surgery can affect patients' quality of life, and their complications may negatively affect patients' long-term outcomes and quality of life. The purpose of this study is to investigate the relationship between diverting stoma-related complications and nutritional status.

Methods

In a retrospective study of 114 patients aged 65 years and older who underwent diverting loop ileostomy following rectal cancer surgery between June 2004 and March 2011, we analyzed retrospectively diverting stoma-related complications and nutrition status for the following time periods: before stoma construction, before stoma closure, and after stoma closure.

Results

Complications related to the diverting stoma developed in 24 (21.1 %) patients and complications related to stoma closure in 11 (9.6 %) patients. Nutritional screening performed prior to stoma closure showed that patients who experienced stoma formation-related complications had lower albumin levels (P = 0.016) and lower total lymphocytes (P = <0.0001). Body weight loss was more severe in patients with stoma-related complication (P = 0.036).

Conclusions

Diverting stoma-related complications may affect patient's nutritional status. Stoma closure operation and proper nutritional support may be important for avoiding complications and improving patients' long-term outcomes and quality of life.
Literature
1.
Pakkastie TE, Luukkonen PE, Järvinen HJ (1994) Anastomotic leakage after anterior resection of the rectum. Eur J Surg 160:293–297PubMed
2.
Law WI, Chu KW, Ho JW, Chan CW (2000) Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision. Am J Surg 179:92–96PubMedCrossRef
3.
Antonsen HK, Kronborg O (1987) Early complications after low anterior resection for rectal cancer using the EEA stapling device. A prospective trial. Dis Colon Rectum 30:579–583PubMedCrossRef
4.
Karanjia ND, Corder AP, Holdsworth PJ, Heald RJ (1991) Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis. Br J Surg 78:196–198PubMedCrossRef
5.
Shabbir J, Britton DC (2010) Stoma complications: a literature overview. Colorectal Dis 12:958–964PubMedCrossRef
6.
7.
Arumugam PJ, Bevan L, Macdonald L, Watkins AJ, Morgan AR, Beynon J (2003) A prospective audit of stomas—analysis of risk factors and complications and their management. Colorectal Dis 5:49–52PubMedCrossRef
8.
Caricato M, Ausania F, Ripetti V, Bartolozzi F, Campoli G, Cappola R (2007) Retrospective analysis of long-term defunctioning stoma complications after colorectal surgery. Colorectal Dis 9:559–561PubMedCrossRef
9.
Marik PE, Zaloga GP (2010) Immunonutrition in high-risk surgical patients: a systemic review and analysis of the literature. JPEN J Parenter Enteral Nutr 34:378–386PubMedCrossRef
10.
Cerantola Y, Hübner M, Grass F, Demartines N, Schäfer M (2011) Immunonutrition in gastrointestinal surgery. Br J Surg 98:37–48PubMedCrossRef
11.
Schiesser M, Műller S, Kirchhoff P, Breitenstein S, Schäfer M, Clavien PA (2008) Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr 27:565–570PubMedCrossRef
12.
Norman K, Pichard C, Lochs H, Pirlich M (2008) Prognostic impact of disease-related malnutrition. Clin Nutr 27:5–15PubMedCrossRef
13.
Kim SY, Yeom HS, Park YM, Chung SH, Shin AR, Han HS, Park DJ (2009) Comparison of tools for nutritional risk screening at hospital admission. KJPEN 2:6–12
14.
Matthiessen P, Hallböök O, Rutegård J, Sjödahl R (2006) Population-based study of risk factors for postoperative death after anterior resection of the rectum. Br J Surg 93:498–503PubMedCrossRef
15.
Peeters KC, Tollenaar RA, Marijnen CA, Klein Kranenbarg E, Steup WH, Wiggers T, Rutten HJ, van de Velde CJ, Dutch Colorectal Cancer Group (2005) Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg 92:211–216PubMedCrossRef
16.
Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D (2006) Morbidity of temporary loop ileostomy in patients with colorectal cancer. Dis Colon Rectum 49:1011–1017PubMedCrossRef
17.
Griep MI, Mets TF, Collys K, Ponjaert-Kristoffersen I, Massart DL (2000) Risk of malnutrition in retirement homes elderly persons measured by the "mini-nutritional assessment". J Gerontol A Biol Sci Med Sci 55:M57–63PubMedCrossRef
18.
Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E (2008) Radomized clinical trial of early versus delayed temporary stoma closure after proctectomy. Br J Surg 95:693–698PubMedCrossRef
19.
Gérard JP, Conroy T, Bonnetain F, Bouché O, Chapet O, Closon-Dejardin MT, Untereiner M, Leduc B, Francois E, Maurel J, Seitz JF, Buecher B, Mackiewicz R, Ducreux M, Bedenne L (2006) Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 24:4620–4625PubMedCrossRef
20.
Mullen JL, Buzby GP, Matthews DC, Smale BF, Rosato EF (1980) Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg 192:604–613PubMed
21.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M, Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN) (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22:415–421PubMedCrossRef
22.
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Ad Hoc ESPEN Working Group (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22:321–336PubMedCrossRef
Metadata
Title
The nutritional impact of diverting stoma-related complications in elderly rectal cancer patients
Authors
Bong-Hyeon Kye
Hyung-Jin Kim
Jun-Gi Kim
Hyeon-Min Cho
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 10/2013
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-013-1699-4

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