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- Title
Complications of Diverting Ileostomy after Low Anterior Resection for Rectal Carcinoma.
- Authors
MARONEY, SEAN; DE PAZ, CARLOS CHAVEZ; DULDULAO, MARJUNPHILIP; TRACEY KIM; REEVES, MARK E.; KAZANJIAN, KEVORK K.; SOLOMON, NAVEENRAJ; GARBEROGLIO, CARLOS; Chavez de Paz, Carlos; Kim, Tracey
- Abstract
There have been few studies directly comparing the postoperative complications in patients with a diverting ileostomy to patients who were not diverted after low anterior resection (LAR) for rectal carcinoma. This study is a retrospective chart review of all rectal carcinoma patients (99) who underwent a LAR from January 2009 to December 2014 at Loma Linda University Medical Center and Veterans Affairs Loma Linda Healthcare System. A majority of patients were diverted (58% vs 42%). The diverted patients were more likely to have a low tumor location (P < 0.01), preoperative chemoradiation (P < 0.01), and more intraoperative blood loss (P < 0.01). Our study shows a statistically significant higher overall complication rate among patients receiving a diverting ileostomy in the six months after LAR (61% vs 38%, P = 0.02). The difference is due to a higher rate of readmission (27% vs 14%) and acute kidney injury (14% vs 5%) in patients with a diverting ileostomy. It also shows that there is a higher rate of unplanned reoperation (11% vs 6%) due to anastomotic leak (17% vs 5%) in nondiverted patients. Further studies are needed to refine the specific indications to maximize the benefit of diverting ileostomy after LAR for rectal carcinoma.
- Subjects
RECTAL cancer treatment; ILEOSTOMY complications; CHEMORADIOTHERAPY; CANCER treatment complications; SURGICAL drainage; RECTAL surgery; ACADEMIC medical centers; COLECTOMY; COMPARATIVE studies; LENGTH of stay in hospitals; ILEOSTOMY; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RECTUM tumors; REOPERATION; RESEARCH; SURGICAL complications; SURVIVAL analysis (Biometry); EVALUATION research; RETROSPECTIVE studies; SURGICAL anastomosis
- Publication
American Surgeon, 2016, Vol 82, Issue 10, p1033
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481608201039