Small bowel obstruction following low anterior resection: the impact of diversion ileostomy

Poon, Jensen T. C.; Law, Wai‐Lun; Chu, Kin Wah

doi:10.1007/s00423-004-0467-x

Cited by 25 publications

(23 citation statements)

References 20 publications

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“…SBO after diverting loop‐ileostomy also often occurs after rectal cancer surgery. The incidence of SBO after diverting loop‐ileostomy in rectal cancer surgery is at most 10% to 14%,19, 20, 21 whereas the incidence of SBO after UC surgery is higher in some reports (15‐24%) 22, 23, 24. These reported rates are similar to our survey results.…”

Section: Discussionsupporting

confidence: 89%

Risk factors of small bowel obstruction following total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy for ulcerative colitis

Mizushima

Kameyama

Watanabe

et al. 2017

Annals of Gastroent Surgery

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Small bowel obstruction (SBO) often occurs after total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy for ulcerative colitis. Little is known about the association between SBO and surgical procedures for diverting loop‐ileostomy. We conducted a multicenter, retrospective questionnaire survey. Unlinkable anonymized data on ileostomy procedures and ileostomy‐related complications including SBO were collected from institutions specializing in surgery for inflammatory bowel disease. In total, 515 patients undergoing total proctocolectomy and ileal pouch anal anastomosis with loop‐ileostomy among 1022 patients with ulcerative colitis undergoing surgery during a 3‐year period between 2012 and 2014 were analyzed. Twenty‐nine patients without information on complications were excluded. Incidence of ileostomy‐related complications and factors associated with the development of small bowel obstruction were determined in 486 patients. The most common complications were parastomal dermatitis (n=169, 34.8%), SBO (n=111, 22.8%), mucocutaneous dehiscence (n=59, 12.1%), stoma prolapse (n=21, 4.3%), parastomal hernia (n=12, 2.5%), and stoma retraction (n=11, 2.3%). Incidence of small bowel obstruction was significantly higher in patients with distance from the ileal pouch to the ileostomy of less than 30 cm and in patients undergoing laparoscopic surgery. Procedures for diverting loop‐ileostomy after surgery for ulcerative colitis varied among institutions. Incidence of small bowel obstruction was high after total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy. Shorter distance between the pouch and the stoma and the laparoscopic surgery were risk factors for SBO in univariate analysis.

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Section: Discussionsupporting

confidence: 89%

Risk factors of small bowel obstruction following total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy for ulcerative colitis

Mizushima

Kameyama

Watanabe

et al. 2017

Annals of Gastroent Surgery

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“…Our current study identified an EPSBO rate of 3.5% following colon cancer surgery, which correlates with the lower end of the reported range of 3.6-10.3% [4][5][6]. Our study differs from previous reports with regard to the homogeneity of our patient population (only colon cancer cases were included) and the exclusion of emergency surgery cases.…”

Section: Discussioncontrasting

confidence: 55%

“…Emergency surgery has been confirmed as a risk factor for EPSBO in previous studies, including in nationwide research [7]. Other previous studies have also included patients who underwent surgery for rectal cancer [5] or inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease [6]. Crohn's disease may impart a severe inflammatory reaction in the small bowel and, therefore, imposes a higher risk for EPSBO [7].…”

Section: Discussionmentioning

confidence: 97%

Risk Factors for Early Postoperative Small Bowel Obstruction after Elective Colon Cancer Surgery: An Observational Study of 1,244 Consecutive Patients

Wang

Chi²,

H³

et al. 2017

Dig Surg

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Background: Early postoperative small bowel obstruction (EPSBO) is a common complication following colon cancer surgery. EPSBO is associated with increased hospital stays, mortality rates, and healthcare costs. The purpose of this study was to identify risk factors for EPSBO following elective colon cancer surgery. Study Design: We retrospectively reviewed the clinicopathological variables of 1,244 patients with colon cancer who underwent partial colectomy from January 2000 to December 2014. A multivariable logistic regression model was used to identify risk factors for EPSBO. Results: The EPSBO rate was 3.5%. In multivariate analysis, preoperative bowel obstruction (OR 2.378; 95% CI 0.986-5.735, p = 0.054), weight loss >10% of body weight (OR 3.029; 95% CI 1.000-9.178, p = 0.05), albumin level (in g/L; OR 0.966; 95% CI 0.937-0.996, p = 0.024), and surgical duration (in min; OR 1.008; 95% CI 1.003-1.012, p = 0.003) were significant predictors of EPSBO. Conclusion: EPSBO is more likely to develop in the presence of poor systemic conditions (e.g., weight loss >10% of body weight, hypoalbuminemia, and preoperative bowel obstruction) and following operations of longer duration. These predictors may facilitate the stratification of patients at risk for EPSBO following surgery for elective colon cancer.

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“…As a result, we propose that the relationship between increased incidence of EPSBO in patients with construction of a diverting ileostomy is not only a reflection of a more challenging surgical procedure but that complications of the ileostomy itself also contributed to the development of EPSBO (Table 4). Similarly, Poon et al 23 determined that diverting ileostomy was associated with an increased incidence of early obstruction in patients with rectal cancer.…”

Section: Discussionmentioning

confidence: 97%

The Incidence and Risk of Early Postoperative Small Bowel Obstruction After Laparoscopic Resection for Colorectal Cancer

Kim

Joo

Kim

et al. 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Early postoperative small bowel obstruction following laparoscopic resection for colorectal cancer occurred in 5.9% of patients. Factors for predicting the development of early postoperative small bowel obstruction in patients with colorectal cancer are variables reflective of a more difficult surgery, rather than pathologic disease severity or anatomical location. In addition, most patients with early postoperative small bowel obstruction improved with conservative treatment, and surgical treatment was rarely needed.

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Small bowel obstruction following low anterior resection: the impact of diversion ileostomy

Cited by 25 publications

References 20 publications

Risk factors of small bowel obstruction following total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy for ulcerative colitis

Risk factors of small bowel obstruction following total proctocolectomy and ileal pouch anal anastomosis with diverting loop‐ileostomy for ulcerative colitis

Risk Factors for Early Postoperative Small Bowel Obstruction after Elective Colon Cancer Surgery: An Observational Study of 1,244 Consecutive Patients

The Incidence and Risk of Early Postoperative Small Bowel Obstruction After Laparoscopic Resection for Colorectal Cancer

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