Journal article
Perioperative Morbidity and Complications in Patients With an Established Ileostomy Undergoing Major Abdominal Surgery: A Retrospective Study
Frontiers in surgery, Vol.8, pp.757269-757269
12/08/2021
DOI: 10.3389/fsurg.2021.757269
PMCID: PMC8692261
PMID: 34957201
Abstract
Background: Recently formed ileostomies may produce an average of 1,200 ml of watery stool per day, while an established ileostomy output varies between 600-800 ml per day. The reported incidence of renal impartment in patients with ileostomy is 8-20%, which could be caused by dehydration (up to 50%) or high output stoma (up to 40%). There is a lack of evidence if an ileostomy could influence perioperative fluid management and/or surgical outcomes.Methods: Subjects aged >= 18 years old with an established ileostomy scheduled to undergo an elective non-ileostomy-related major abdominal surgery under general anesthesia lasting more than 2 h and requiring hospitalization were included in the study. The primary outcome was to assess the incidence of perioperative complications within 30 days after surgery.Results: A total of 552 potential subjects who underwent non-ileostomy-related abdominal surgery were screened, but only 12 were included in the statistical analysis. In our study cohort, 66.7% of the subjects were men and the median age was 56 years old (interquartile range [IQR] 48-59). The median time from the creation of ileostomy to the qualifying surgery was 17.7 months (IQR: 8.3, 32.6). The most prevalent comorbidities in the study group were psychiatric disorders (58.3%), hypertension (50%), and cardiovascular disease (41.7%). The most predominant surgical approach was open (8 [67%]). The median surgical and anesthesia length was 3.4 h (IQR: 2.5, 5.7) and 4 h (IQR: 3, 6.5), respectively. The median post-anesthesia care unit (PACU) stay was 2 h (IQR:0.9, 3.1), while the median length of hospital stay (LOS) was 5.6 days (IQR: 4.1, 10.6). The overall incidence of postoperative complications was 50% (n = 6). Two subjects (16.7%) had a moderate surgical wound infection, and two subjects (16.7%) experienced a mild surgical wound infection. In addition, one subject (7.6%) developed a major postoperative complication with atrial fibrillation in conjunction with moderate hemorrhage.Conclusions: Our findings suggest that the presence of a well-established ileostomy might not represent a relevant risk factor for significant perioperative complications related to fluid management or hospital readmission. However, the presence of peristomal skin complications could trigger a higher incidence of surgical wound infections.
Details
- Title: Subtitle
- Perioperative Morbidity and Complications in Patients With an Established Ileostomy Undergoing Major Abdominal Surgery: A Retrospective Study
- Creators
- Alberto A. Uribe - The Ohio State University Wexner Medical CenterTristan E. Weaver - The Ohio State University Wexner Medical CenterMarco Echeverria-Villalobos - The Ohio State UniversityLuis Periel - The Ohio State University Wexner Medical CenterHaixia Shi - The Ohio State UniversityJuan Fiorda-Diaz - The Ohio State UniversityAlicia Gonzalez-Zacarias - The Ohio State UniversityMahmoud Abdel-Rasoul - The Ohio State UniversityLin Li - The Ohio State University
- Resource Type
- Journal article
- Publication Details
- Frontiers in surgery, Vol.8, pp.757269-757269
- Publisher
- Frontiers Media Sa
- DOI
- 10.3389/fsurg.2021.757269
- PMID
- 34957201
- PMCID
- PMC8692261
- ISSN
- 2296-875X
- eISSN
- 2296-875X
- Number of pages
- 7
- Grant note
- UL1TR002733 / National Center for Advancing Translational Sciences; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 12/08/2021
- Academic Unit
- Anesthesia
- Record Identifier
- 9984656539602771
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