Advanced

Morbidity related to defunctioning loop ileostomy in low anterior resection

Akesson, Oscar; Syk, Ingvar LU ; Lindmark, Gudrun LU and Buchwald, Pamela (2012) In International Journal of Colorectal Disease 27(12). p.1619-1623
Abstract
Aim A defunctioning loop ileostomy in low anterior resection reduces the incidence and morbidity of an anastomotic leakage, but complications related to the stoma may occur. We explored stoma-associated complications during the stoma period and after stoma reversal. Methods A retrospective analysis of rectal cancer patients operated with low anterior resection and a defunctioning loop ileostomy at Helsingborg Hospital and Malmo University Hospital from January 2007 to June 2009 was undertaken. Results Ninety-two patients were included, of whom 82 (89 %) underwent stoma reversal. The median stoma period was 6.2 +/- 3.2 months. Sixty-six percent of the patients suffered from minor or major stoma-associated morbidity. The complication rate... (More)
Aim A defunctioning loop ileostomy in low anterior resection reduces the incidence and morbidity of an anastomotic leakage, but complications related to the stoma may occur. We explored stoma-associated complications during the stoma period and after stoma reversal. Methods A retrospective analysis of rectal cancer patients operated with low anterior resection and a defunctioning loop ileostomy at Helsingborg Hospital and Malmo University Hospital from January 2007 to June 2009 was undertaken. Results Ninety-two patients were included, of whom 82 (89 %) underwent stoma reversal. The median stoma period was 6.2 +/- 3.2 months. Sixty-six percent of the patients suffered from minor or major stoma-associated morbidity. The complication rate was significantly related to the stoma time (p < 0.01). Twenty-nine percent (27/92) had at least one episode of dehydration, leading to readmittance in half of the cases. Elderly patients were more prone to develop dehydration. Dehydration most commonly occurred early in the postoperative period (mean, 5.8 weeks). The mean hospital stay for stoma reversal was 6.5 +/- 4.0 days. Forty percent (33/82) had some complication associated with the reversal. Conclusion This study indicates high morbidity associated with defunctioning loop ileostomy. Our data suggest that the stoma time should be limited to reduce complications. Monitoring and early stoma reversal should be considered in elderly patients. Furthermore, stoma reversal is not uneventful, and more studies are needed to address how to minimize complications. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Defunctioning loop ileostomy, Low anterior resection, Morbidity, Rectal, cancer
in
International Journal of Colorectal Disease
volume
27
issue
12
pages
1619 - 1623
publisher
Springer
external identifiers
  • wos:000312343700009
  • scopus:84874415255
ISSN
1432-1262
DOI
10.1007/s00384-012-1490-y
language
English
LU publication?
yes
id
3cafec10-b1cd-4de7-9cd2-ca49d98c9ba6 (old id 3368005)
date added to LUP
2013-02-01 06:58:33
date last changed
2017-08-06 03:11:09
@article{3cafec10-b1cd-4de7-9cd2-ca49d98c9ba6,
  abstract     = {Aim A defunctioning loop ileostomy in low anterior resection reduces the incidence and morbidity of an anastomotic leakage, but complications related to the stoma may occur. We explored stoma-associated complications during the stoma period and after stoma reversal. Methods A retrospective analysis of rectal cancer patients operated with low anterior resection and a defunctioning loop ileostomy at Helsingborg Hospital and Malmo University Hospital from January 2007 to June 2009 was undertaken. Results Ninety-two patients were included, of whom 82 (89 %) underwent stoma reversal. The median stoma period was 6.2 +/- 3.2 months. Sixty-six percent of the patients suffered from minor or major stoma-associated morbidity. The complication rate was significantly related to the stoma time (p &lt; 0.01). Twenty-nine percent (27/92) had at least one episode of dehydration, leading to readmittance in half of the cases. Elderly patients were more prone to develop dehydration. Dehydration most commonly occurred early in the postoperative period (mean, 5.8 weeks). The mean hospital stay for stoma reversal was 6.5 +/- 4.0 days. Forty percent (33/82) had some complication associated with the reversal. Conclusion This study indicates high morbidity associated with defunctioning loop ileostomy. Our data suggest that the stoma time should be limited to reduce complications. Monitoring and early stoma reversal should be considered in elderly patients. Furthermore, stoma reversal is not uneventful, and more studies are needed to address how to minimize complications.},
  author       = {Akesson, Oscar and Syk, Ingvar and Lindmark, Gudrun and Buchwald, Pamela},
  issn         = {1432-1262},
  keyword      = {Defunctioning loop ileostomy,Low anterior resection,Morbidity,Rectal,cancer},
  language     = {eng},
  number       = {12},
  pages        = {1619--1623},
  publisher    = {Springer},
  series       = {International Journal of Colorectal Disease},
  title        = {Morbidity related to defunctioning loop ileostomy in low anterior resection},
  url          = {http://dx.doi.org/10.1007/s00384-012-1490-y},
  volume       = {27},
  year         = {2012},
}