Aydın Aktaş1, Cüneyt Kayaalp2, Mustafa Ateş3, Abuzer Dirican3. 1. Department of General Surgery, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. 2. Department of Gastointestinal Surgery, İnönü University, School of Medicine, Malatya, Turkey. 3. Department of General Surgery, İnönü University, School of Medicine, Malatya, Turkey.
Abstract
OBJECTIVES: The most common intra-abdominal complication following loop ileostomy closure (LIC) is postoperative ileus (POI). The aim of the study was to determine the risk factors of POI development following LIC and make recommendations for its prevention. MATERIAL AND METHODS: In this study, patients having undergone LIC with peristomal incision following distal colorectal surgery were included. Clavien-Dindo classification was used to evaluate postoperative complications. POI and postoperative leakage were defined based on clinical and radiological criteria. The Centers for Disease Control and Prevention 2017 criteria were used to diagnose surgical site infection (SSI). Postoperative bleeding was diagnosed one day after surgery if there was a >2 g/dL or ≥15% decrease in the hemoglobin level. RESULTS: Seventy-nine patients were included into the study. In nine of the patients POI developed, six had SSI, five had postoperative bleeding, and two had anastomosis leakage. In the univariate analysis; age <60 years (p= 0.02), presence of comorbidity (p= 0.007), using an open technique in the first surgery (p= 0.02), performing total colectomy in the first surgery (p= 0.048), performing hand-sewn anastomosis of LIC (p= 0.01), and postoperative blood transfusion (p= 0.04) were found to be risk factors for POI. Performing hand-sewn anastomosis of LIC (p= 0.03) and using an open technique in the first surgery (p= 0.03) were found to be independent variables for POI risk. CONCLUSION: Using an open technique in the first surgery and performing a hand-sewn anastomosis of LIC may increase POI.
OBJECTIVES: The most common intra-abdominal complication following loop ileostomy closure (LIC) is postoperative ileus (POI). The aim of the study was to determine the risk factors of POI development following LIC and make recommendations for its prevention. MATERIAL AND METHODS: In this study, patients having undergone LIC with peristomal incision following distal colorectal surgery were included. Clavien-Dindo classification was used to evaluate postoperative complications. POI and postoperative leakage were defined based on clinical and radiological criteria. The Centers for Disease Control and Prevention 2017 criteria were used to diagnose surgical site infection (SSI). Postoperative bleeding was diagnosed one day after surgery if there was a >2 g/dL or ≥15% decrease in the hemoglobin level. RESULTS: Seventy-nine patients were included into the study. In nine of the patients POI developed, six had SSI, five had postoperative bleeding, and two had anastomosis leakage. In the univariate analysis; age <60 years (p= 0.02), presence of comorbidity (p= 0.007), using an open technique in the first surgery (p= 0.02), performing total colectomy in the first surgery (p= 0.048), performing hand-sewn anastomosis of LIC (p= 0.01), and postoperative blood transfusion (p= 0.04) were found to be risk factors for POI. Performing hand-sewn anastomosis of LIC (p= 0.03) and using an open technique in the first surgery (p= 0.03) were found to be independent variables for POI risk. CONCLUSION: Using an open technique in the first surgery and performing a hand-sewn anastomosis of LIC may increase POI.
Authors: Thorsten Löffler; Inga Rossion; Thomas Bruckner; Markus K Diener; Moritz Koch; Moritz von Frankenberg; Julius Pochhammer; Oliver Thomusch; Thomas Kijak; Thomas Simon; André L Mihaljevic; Matthias Krüger; Erwin Stein; Gerald Prechtl; René Hodina; Walter Michal; Roland Strunk; Karl Henkel; Jörg Bunse; Gregor Jaschke; Dirk Politt; Hans Peter Heistermann; Mathis Fußer; Claas Lange; Achim Stamm; Andreas Vosschulte; Ralf Holzer; Lars Ivo Partecke; Emanuel Burdzik; Hubert M Hug; Steffen P Luntz; Meinhard Kieser; Markus W Büchler; Jürgen Weitz Journal: Ann Surg Date: 2012-11 Impact factor: 12.969
Authors: Mónica Mengual-Ballester; José Andrés García-Marín; Enrique Pellicer-Franco; María Pilar Guillén-Paredes; María Luisa García-García; María José Cases-Baldó; José Luis Aguayo-Albasini Journal: Rev Esp Enferm Dig Date: 2012-07 Impact factor: 2.086