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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japan Society of Coloproctology
2024-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/8/1/8_2023-018/_pdf/-char/en |
| _version_ | 1797346883567353856 |
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| author | Keisuke Ihara Takatoshi Nakamura Masashi Takayanagi Junki Fujita Yasunori Maeda Yusuke Nishi Norisuke Shibuya Hiroyuki Hachiya Mitsuru Ishizuka Keiichi Tominaga Kazuyuki Kojima Atsushi Irisawa |
| author_facet | Keisuke Ihara Takatoshi Nakamura Masashi Takayanagi Junki Fujita Yasunori Maeda Yusuke Nishi Norisuke Shibuya Hiroyuki Hachiya Mitsuru Ishizuka Keiichi Tominaga Kazuyuki Kojima Atsushi Irisawa |
| author_sort | Keisuke Ihara |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T11:39:39Z |
| format | Article |
| id | doaj.art-ac5aa43dd07b4b858c7fa8d0bb1ea41f |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-03-08T11:39:39Z |
| publishDate | 2024-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-ac5aa43dd07b4b858c7fa8d0bb1ea41f2024-01-25T07:45:34ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532024-01-0181182310.23922/jarc.2023-0182023-018Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative ColitisKeisuke Ihara0Takatoshi Nakamura1Masashi Takayanagi2Junki Fujita3Yasunori Maeda4Yusuke Nishi5Norisuke Shibuya6Hiroyuki Hachiya7Mitsuru Ishizuka8Keiichi Tominaga9Kazuyuki Kojima10Atsushi Irisawa11Center for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalDepartment of Surgical Oncology, Dokkyo Medical UniversityCenter for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalCenter for Colorectal Surgery, Dokkyo Medical University HospitalDepartment of Gastroenterology, Dokkyo Medical UniversityDepartment of Surgical Oncology, Dokkyo Medical UniversityCenter for Colorectal Surgery, Dokkyo Medical University HospitalObjectives: 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.https://www.jstage.jst.go.jp/article/jarc/8/1/8_2023-018/_pdf/-char/enstoma outlet obstructionulcerative colitisrisk factordiverting ileostomypostoperative complication |
| spellingShingle | Keisuke Ihara Takatoshi Nakamura Masashi Takayanagi Junki Fujita Yasunori Maeda Yusuke Nishi Norisuke Shibuya Hiroyuki Hachiya Mitsuru Ishizuka Keiichi Tominaga Kazuyuki Kojima Atsushi Irisawa Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis Journal of the Anus, Rectum and Colon stoma outlet obstruction ulcerative colitis risk factor diverting ileostomy postoperative complication |
| title | Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis |
| title_full | Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis |
| title_fullStr | Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis |
| title_full_unstemmed | Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis |
| title_short | Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis |
| title_sort | risk factors for stoma outlet obstruction after proctocolectomy for ulcerative colitis |
| topic | stoma outlet obstruction ulcerative colitis risk factor diverting ileostomy postoperative complication |
| url | https://www.jstage.jst.go.jp/article/jarc/8/1/8_2023-018/_pdf/-char/en |
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