Day‐case closure of ileostomy: feasible, safe and efficient

Bhalla, Ashish; Peacock, Oliver; Tierney, Gillian; Tou, Samson; Hurst, Nicholas; Speake, WJ; Williams, John P.; Lund, Jonathan N.

doi:10.1111/codi.12961

Cited by 34 publications

(17 citation statements)

References 11 publications

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“…The same planning could be applied to ileostomy reversal cases, where patients identified as high-risk are directed to specialty care centers that are better equipped to manage higher complexity patients. Equally, low risk cases could be identified for same day discharge after reversal, so reducing average LOS [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of complications from stoma closure in elective colorectal surgery: an assessment from the American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP)

et al. 2020

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Background There is significant morbidity after diverting ileostomy closure, so identifying predictors of complications could be of great benefit. The aim of our study was to evaluate the incidence and risk factors for postoperative morbidity after elective ileostomy closure. Methods The ACS-NSQIP dataset was evaluated for elective ileostomy closures from 1/1/2015 to 12/31/2016. Demographic characteristics, operative, and postoperative outcomes were evaluated. The primary outcome was 30-day major morbidity (Clavien class III and greater). Secondary outcomes were rates and predictors of major morbidity, superficial site infection (SSI), reoperation, and readmission from multivariate logistic regression modeling. Results We retrospectively evaluated 1885 patients. The median operative time was 65 (IQR 50–90) minutes and median length of stay was 3 (IQR 2–5) days. Major morbidity was recorded in 6.7%, including mortality (1.0%), deep/organ space SSI (2.6%), dehiscence (0.8%), reintubation (0.5%), sepsis (1.7%), septic shock (0.8%), and reoperation (3.7%). Readmission was recorded in 9.7% and 6.2% had SSI. Multivariate logistic regression showed male sex (OR 1.584; 95% CI 1.068–2.347; p = 0.022) and longer operative time (OR 1.004; 95% CI 1.001–1.007; p = 0.009) were among those variables associated with increased odds of major morbidity. Dyspnea (OR 2.431; 95% CI 1.139–5.094; p = 0.021) and longer operative time (OR 1.003; 95% CI 1.001–1.007; p = 0.034) were among the independent risk factors for SSI. Male sex (OR 2.246; 95% CI 1.297–3.892; p = 0.004, chronic obstructive pulmonary disease (OR 2.959; 95% CI 1.153–7.591; p = 0.024), and longer operative time (OR 1.005; 95% CI 1.001–1.009; p = 0.011) were associated with increased odds of reoperation. Chronic obstructive pulmonary disease (OR 2.578; 95% CI 1.338–4.968; p = 0.005), wound infection (OR 2.680; 95% CI 1.043–6.890; p = 0.041), and inflammatory bowel disease (OR 2.565; 95% CI 1.203–5.463; p = 0.015) were associated with increased odds of readmission. Conclusions Elective stoma closure has significant risk of morbidity. Patients with longer operative times were at increased risk for major morbidity, overall SSI, and reoperation. From the analysis, factors specifically associated with major morbidity, overall infectious complications, readmissions, and reoperations were identified. This information can be used to prospectively prepare for these high-risk patients, potentially improving postoperative outcomes. Electronic supplementary material The online version of this article (10.1007/s10151-020-02307-5) contains supplementary material, which is available to autho...

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Section: Discussionmentioning

confidence: 99%

Predictors of complications from stoma closure in elective colorectal surgery: an assessment from the American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP)

et al. 2020

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“…The primary strength of this study is the large sample size collected over a 10‐year study period. The apparent evolution of patient care over that time reflects a global trend towards minimizing hospital stay and expanding outpatient care for surgery . A limitation of this study is selection bias in the two groups we used for comparison.…”

Section: Discussionmentioning

confidence: 99%

Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients

et al. 2018

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“…POI is the most common complication following LIC with a rate of 4.1% -32.6% (2)(3)(4). POI is the biggest obstacle for a successful enhanced recovery after surgery protocols (8,9), and it is the most important cause of hospitalization within the first 30 days postoperatively (10). POI rises healthcare costs by increasing the risk of hospital-acquired infections (5,6), and it usually improves with conservative treatment (11).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative ileus following loop ileostomy closure

et al. 2020

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Day‐case closure of ileostomy: feasible, safe and efficient

Abstract: Our early experience shows that day-case loop ileostomy closure is feasible, safe and efficient. This protocol will become standard within our institution for suitable patients, saving on average five inpatient bed days per patient.

Cited by 34 publications

References 11 publications

Predictors of complications from stoma closure in elective colorectal surgery: an assessment from the American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP)

Predictors of complications from stoma closure in elective colorectal surgery: an assessment from the American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP)

Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients

Risk factors for postoperative ileus following loop ileostomy closure

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