Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis

Objectives: Stoma outlet obstruction (SOO) occurs with an incidence of approximately 40% after proctocolectomy for Ulcerative colitis (UC) with diverting ileostomy. This study aimed to identify the risk factors for SOO after proctocolectomy with diverting ileostomy for patients with UC. Methods: We...

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Main Authors: Keisuke Ihara, Takatoshi Nakamura, Masashi Takayanagi, Junki Fujita, Yasunori Maeda, Yusuke Nishi, Norisuke Shibuya, Hiroyuki Hachiya, Mitsuru Ishizuka, Keiichi Tominaga, Kazuyuki Kojima, Atsushi Irisawa
Format: Article
Language:English
Published: The Japan Society of Coloproctology 2024-01-01
Series:Journal of the Anus, Rectum and Colon
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Online Access:https://www.jstage.jst.go.jp/article/jarc/8/1/8_2023-018/_pdf/-char/en
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Summary:Objectives: Stoma outlet obstruction (SOO) occurs with an incidence of approximately 40% after proctocolectomy for Ulcerative colitis (UC) with diverting ileostomy. This study aimed to identify the risk factors for SOO after proctocolectomy with diverting ileostomy for patients with UC. Methods: We reviewed the data of 68 patients with UC who underwent proctocolectomy and diverting ileostomy between April 2006 and September 2021. These cases were analyzed on the basis of clinicopathological and anatomical factors. SOO was defined as small bowel obstruction displaying symptoms of intestinal obstruction, such as abdominal distention, abdominal pain, insertion of a tube through the stoma. Results: The study included 38 (56%) men and 30 (44%) women with a median age of 42 years (range, 21-80). SOO categorized as at least Clavien-Dindo grade II occurred in 11 (16%) patients. Six patients required earlier stoma closure than scheduled. Compared with patients without SOO, patients with SOO had a significantly higher total steroid dose from the onset of UC to surgery (p = 0.02), a small amount of intraabdominal fat (p = 0.04), and a higher rate of laparoscopic surgery (p < 0.01). Conclusions: A high preoperative steroid dose, a small amount of intraabdominal fat and laparoscopic surgery were identified as risk factors for SOO. Early detection and treatment for SOO are important for patients at risk.
ISSN:2432-3853