Risk factors for developing high-output ileostomy in CRC patients: a retrospective study

Abstract

Background Anastomotic leakage is one of the most serious postoperative complications of rectal cancer. Prophylactic ileostomy has been widely used to reduce the risk and severity of complications of anastomotic leakage. However, prophylactic ileostomy itself has some complications, and ileostomy high output syndrome (HOS) is one of them. This study was performed to explore the risk factors of HOS in ileostomy. Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last 5 years. The relationship between HOS and the clinicopathological data was analyzed using the Chi-square test and Fisher’s exact probability. Multivariate analysis was performed by logistic regression. Results The incidence of HOS was 23.07% in this study. Dehydration was the most common symptom of HOS (37.7%). There was no clear correlation between HOS occurrence with sex, age, gross typing, histological grade, tumor location, lymph node metastasis, and TNM stage (p > 0.05). The incidence of HOS was 14/18 in inflammatory bowel disease patients, 18/28 in diabetes mellitus patients, and 23/72 in neoadjuvant chemoradiotherapy patients, 13/17 in total colectomy and abdominal infection patients. Multivariate analysis showed that they are risk factors for HOS (p < 0.05). Conclusion HOS occurred occasionally but rarely studied and lacks attention. Inflammatory bowel disease, diabetes mellitus, neoadjuvant radiotherapy chemotherapy, total colectomy and abdominal infection are the risk factors for HOS.

Ghost Ileostomy Versus Loop Ileostomy Following Oncologic Resection for Rectal Cancer: A Systematic Review and Meta-Analysis

“…41 Highoutput ileostomies in particular can occur in 5-25% of cases following TME for rectal cancer with diverting loop ileostomy and may account for up to a 17% readmission rate following these procedures. [42][43][44][45] Readmissions for these patients can cost upwards of $4000 per patient. 46 In addition, ileostomies can have a detrimental impact on patient quality of life (QoL).…”

CE: Caring for Patients After Ileostomy Surgery

“…16 However, some ileostomies can have a high output, which is defined as more than 2,000 mL per day. 17 Tracking output. Strict recording of output must be maintained when monitoring the hydration status of a patient with an ileostomy.…”

“…This amount should decrease over time, as the body heals and adapts to the ileostomy 16. However, some ileostomies can have a high output, which is defined as more than 2,000 mL per day 17…”

Nutritional management of a malnourished cancer patient with high output ileostomy

“…High output stoma as one of surgery complications is still commonly found with incidence of 23%. 1,2 There is no consensus on the definition of high output stoma, ranging from more than 1000 to 2000 mL/day, but clinically ileostomy effluent of more than 2000 mL per day can lead to significant fluid and electrolyte loss. Further it can cause malnutrition, dehydration, electrolyte imbalance, and also renal failure.…”