Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy

Ryo Maemoto; Shingo Tsujinaka; Yasuyuki Miyakura; Rintaro Fukuda; Nao Kakizawa; Tsutomu Takenami; Erika Machida; Nozomi Kikuchi; Rina Kanemitsu; Sawako Tamaki; Hideki Ishikawa; Toshiki Rikiyama

Asian Journal of Surgery (Aug 2021)

Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy

Ryo Maemoto,
Shingo Tsujinaka,
Yasuyuki Miyakura,
Rintaro Fukuda,
Nao Kakizawa,
Tsutomu Takenami,
Erika Machida,
Nozomi Kikuchi,
Rina Kanemitsu,
Sawako Tamaki,
Hideki Ishikawa,
Toshiki Rikiyama

Affiliations

Ryo Maemoto: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Shingo Tsujinaka: Corresponding author. Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya-ku, Saitama-shi, Saitama, 330-8503, Japan.; Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Yasuyuki Miyakura: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Rintaro Fukuda: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Nao Kakizawa: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Tsutomu Takenami: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Erika Machida: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Nozomi Kikuchi: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Rina Kanemitsu: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Sawako Tamaki: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Hideki Ishikawa: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Toshiki Rikiyama: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan

Journal volume & issue: Vol. 44, no. 8
pp. 1037 – 1042

Abstract

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Background: Stoma-related obstruction (SRO) is defined as small bowel obstruction occurring around the limbs of diverting ileostomy (DI). This study was aimed to investigate the incidence, risk factors, and management of SRO after laparoscopic colorectal surgery with DI creation. Methods: This study included 155 patients who underwent laparoscopic colorectal surgery with DI creation for rectal cancer (n = 138), ulcerative colitis (UC) (n = 14), and familial adenomatous polyposis (FAP) (n = 3) between 2011 and 2019. Univariate and multivariate analyses were performed to identify the risk factors of SRO. Results: The incidence of SRO was 7.7% (n = 12), and it was significantly lower (P < 0.01) in patients with lower anterior resection or intersphincteric resection (4.3%) than in those with ileal-pouch anal anastomosis (IPAA) (35.2%). The multivariate analysis revealed that IPAA was independently associated with the development of SRO (P = 0.001; odds ratio, 9.4; 95% confidence interval, 2.5–35.4). Eleven of 12 patients (92%) with SRO required trans-stomal tube decompression, and 8 of those (67%) underwent early stoma closure. Conclusion: IPAA was an independent risk factor of SRO in laparoscopic colorectal surgery with DI creation. Early stoma closure was needed in most cases of SRO.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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