Journal of the Anus, Rectum and Colon
Online ISSN : 2432-3853
ISSN-L : 2432-3853
Original Research Article
Risk Factors for Outlet Obstruction in Patients with Diverting Ileostomy Following Rectal Surgery
Tomoki AbeJunichi NishimuraMasayoshi YasuiChu MatsudaNaotsugu HaraguchiNozomu NakaiHiroshi WadaHidenori TakahashiTakeshi OmoriHiroshi MiyataMasayuki Ohue
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JOURNAL OPEN ACCESS

2021 Volume 5 Issue 3 Pages 254-260

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Abstract

Objectives: Anastomotic leakage is one of the most severe complications of rectal cancer surgery. A diverting ileostomy was constructed for the purpose of reducing anastomotic failure risk. Outlet obstruction (OO) is one of the complications of diverting stoma that results in a lack of fecal discharge from the stoma. Detailed etiologies and preventive measures for outlet obstruction have not yet been identified.

Methods: We studied 125 patients who underwent rectal resection, anastomosis, and elective ileostomy. We evaluated the incidence of outlet obstruction and looked for any relationship between perioperative factors and outlet obstruction.

Results: Outlet obstruction was detected in 20 cases (16.0%). Outlet obstruction occurred 9 days after surgery in most cases. Inserting a decompressing tube improved obstructive symptoms in 4 days. Patients were divided into two cohorts according to the occurrence of outlet obstruction. Postoperative hospital stay was longer in the outlet obstruction group (19 vs. 15 days; p = 0.0003). A multivariate analysis identified that younger patients, a postoperative thicker rectus abdominis muscle at the stoma passage and high output syndrome were independent risk factors for outlet obstruction.

Conclusions: Younger patients, a postoperative thicker rectus abdominis muscle at stoma passage and high output syndrome were independent risk factors for outlet obstruction.

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© 2021 The Japan Society of Coloproctology

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