Mizunori Yaegashi1,2, Koki Otsuka3, Toshimoto Kimura3, Teppei Matsuo3, Hitoshi Fujii3, Kei Sato3, Kiyoharu Takashimizu3, Tomoki Hatanaka3, Toru Yoshida4, Chihiro Tono4, Akira Sasaki3. 1. Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori Yahaba, Shiwa, Iwate, 028-3695, Japan. ymizunori@gmail.com. 2. Department of Surgery, Iwate Prefectural Kuji Hospital, 10-1 Asahimati, Kuji, Iwate, 028-0014, Japan. ymizunori@gmail.com. 3. Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori Yahaba, Shiwa, Iwate, 028-3695, Japan. 4. Department of Surgery, Iwate Prefectural Kuji Hospital, 10-1 Asahimati, Kuji, Iwate, 028-0014, Japan.
Abstract
PURPOSE: Loop ileostomy is often used to prevent complications after colorectal surgery, but it has been reported to cause renal impairment. This study aimed to evaluate the changes in the renal function after ileostomy and to compare these with the renal function after low anterior resection without ileostomy (low-ANT). METHODS: The subjects included 58 patients who underwent ileostomy construction and closure for rectal cancer. The estimated glomerular filtration rate (eGFR) was calculated at specific time points after the index surgery. In addition, we conducted a case-matched study on 147 patients who underwent low-ANT. RESULTS: The eGFR was significantly lower at 1 month after ileostomy than at the time of ileostomy construction (78.8 vs. 84.0, p < 0.0001) and did not improve after ileostomy closure. The only risk factor for a reduced eGFR was preoperative chemotherapy or chemoradiotherapy. In the case-matched study, 36 patients were allocated for each of the two groups. The number of ileostomy patients with a reduced eGFR was significantly increased 1 month after the index surgery (p = 0.005). CONCLUSIONS: The eGFR began to decrease at one month after ileostomy construction and did not improve after ileostomy closure.
PURPOSE: Loop ileostomy is often used to prevent complications after colorectal surgery, but it has been reported to cause renal impairment. This study aimed to evaluate the changes in the renal function after ileostomy and to compare these with the renal function after low anterior resection without ileostomy (low-ANT). METHODS: The subjects included 58 patients who underwent ileostomy construction and closure for rectal cancer. The estimated glomerular filtration rate (eGFR) was calculated at specific time points after the index surgery. In addition, we conducted a case-matched study on 147 patients who underwent low-ANT. RESULTS: The eGFR was significantly lower at 1 month after ileostomy than at the time of ileostomy construction (78.8 vs. 84.0, p < 0.0001) and did not improve after ileostomy closure. The only risk factor for a reduced eGFR was preoperative chemotherapy or chemoradiotherapy. In the case-matched study, 36 patients were allocated for each of the two groups. The number of ileostomy patients with a reduced eGFR was significantly increased 1 month after the index surgery (p = 0.005). CONCLUSIONS: The eGFR began to decrease at one month after ileostomy construction and did not improve after ileostomy closure.
Authors: I Vogel; M Shinkwin; S L van der Storm; J Torkington; J A Cornish; P J Tanis; R Hompes; W A Bemelman Journal: Tech Coloproctol Date: 2022-02-22 Impact factor: 3.699
Authors: Marcin Zeman; Marek Czarnecki; Andrzej Chmielarz; Adam Idasiak; Maciej Grajek; Agnieszka Czarniecka Journal: World J Surg Oncol Date: 2020-08-14 Impact factor: 2.754