Individual surgeon practice is the most important factor influencing diverting loop ileostomy creation for patients undergoing sigmoid colectomy for diverticulitis

Cigdem Benlice; Conor P Delaney; David Liska; Jennifer Hrabe; Scott Steele; Emre Gorgun

doi:10.1016/j.amjsurg.2017.10.046

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Individual surgeon practice is the most important factor influencing diverting loop ileostomy creation for patients undergoing sigmoid colectomy for diverticulitis

Journal article

Peer reviewed

Individual surgeon practice is the most important factor influencing diverting loop ileostomy creation for patients undergoing sigmoid colectomy for diverticulitis

Cigdem Benlice, Conor P Delaney, David Liska, Jennifer Hrabe, Scott Steele and Emre Gorgun

The American journal of surgery, Vol.215(3), pp.442-445

03/2018

DOI: 10.1016/j.amjsurg.2017.10.046

PMID: 29153979

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Abstract

To identify factors associated with diverting ileostomy creation (DLI) in patients undergoing sigmoid colectomy for diverticular disease in a high volume colorectal unit and to obtain information for better preoperative patient counseling. Patients who underwent sigmoid colectomy with colorectal anastomosis with or without DLI for diverticulitis between 01/1994-12/2014 were identified. Preoperative characteristics, surgeon practice year, individual surgeon and postoperative outcomes were compared between patients with DLI or not. 1320 patients were identified and DLI was created in 204 (15.4%) patients. DLI creation was associated with older age (p < 0.001), female gender (p = 0.01), higher ASA-class (p < 0.001), hypertension (p = 0.01), DM(p < 0.001), renal comorbidities (p < 0.001), preoperative steroid use (p = 0.03), preoperative anemia (p = 0.004), and open surgery (p < 0.001). While ileostomy creation rates did not vary over the years during the study period or with increased surgeons' experience, surgeon identity had significant impact on ileostomy creation (Rate range 6.8-60.7%, p < 0.001). Multivariate logistic regression analysis revealed that individual surgeon, open approach, preoperative steroid use, and disease-related factors remained independently associated with DLI creation. Individual surgeon's practice affects the rate of diverting ileostomy creation in patients undergoing sigmoid colectomy for diverticular disease.

Diverticulitis, Colonic - surgery

Colon, Sigmoid - surgery

Humans

Middle Aged

Logistic Models

Male

Treatment Outcome

Colectomy

Practice Patterns, Physicians' - statistics & numerical data

Procedures and Techniques Utilization - statistics & numerical data

Female

Aged

Retrospective Studies

Ileostomy - statistics & numerical data

Details

Title: Subtitle: Individual surgeon practice is the most important factor influencing diverting loop ileostomy creation for patients undergoing sigmoid colectomy for diverticulitis
Creators: Cigdem Benlice - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
Conor P Delaney - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
David Liska - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
Jennifer Hrabe - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
Scott Steele - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
Emre Gorgun - Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: gorgune@ccf.org
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.215(3), pp.442-445
Publisher: United States
DOI: 10.1016/j.amjsurg.2017.10.046
PMID: 29153979
ISSN: 0002-9610
eISSN: 1879-1883
Language: English
Date published: 03/2018
Academic Unit: Surgery
Record Identifier: 9984051594302771

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