Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery
Objectives: In surgery for lower rectal cancer, temporary ileostomy can be created to avoid complications, such as anastomotic leakage. However, various complications may occur with the stoma, including stoma outlet obstruction (SOO). The occurrence of SOO can prolong the length of hospital stay and...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-04-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/2/9_2024-109/_pdf/-char/en |
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| _version_ | 1849311052261490688 |
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| author | Chiharu Yasui Kyoichi Kihara Ryo Ishiguro Takuki Yagyu Yusuke Kono Manabu Yamamoto Tomoyuki Matsunaga Naruo Tokuyasu Teruhisa Sakamoto Yoshiyuki Fujiwara |
| author_facet | Chiharu Yasui Kyoichi Kihara Ryo Ishiguro Takuki Yagyu Yusuke Kono Manabu Yamamoto Tomoyuki Matsunaga Naruo Tokuyasu Teruhisa Sakamoto Yoshiyuki Fujiwara |
| author_sort | Chiharu Yasui |
| collection | DOAJ |
| description | Objectives: In surgery for lower rectal cancer, temporary ileostomy can be created to avoid complications, such as anastomotic leakage. However, various complications may occur with the stoma, including stoma outlet obstruction (SOO). The occurrence of SOO can prolong the length of hospital stay and delay the introduction of adjuvant chemotherapy, which can negatively affect the prognosis. We retrospectively reviewed cases of temporary ileostomy at our hospital and evaluated the risk factors for SOO.
Methods: We extracted data pertaining to patients with temporary ileostomy created during surgery for rectal cancer from 2013 to 2023, and compared clinicopathologic factors or short-term outcomes, with or without SOO complications. We scored the independent factors obtained and created predictive scoring model for SOO.
Results: Total of 107 patients were included. SOO was observed in 21 patients (19.6%), all of whom were male. SOO was most frequently diagnosed on sixth postoperative day. In most cases, feeding resumed 4 days after the diagnosis of SOO. Age (67 years; p = 0.002), rectus abdominis muscle thickness (13.5 mm; p < 0.001) and the amount of stoma output greater than 1,500 ml/day within 3 days of surgery (p < 0.001) were independent risk factors for SOO. The preoperative and early postoperative predictive scoring model, created by adding one point to each risk factor, predicted SOO with sensitivity of 76.2%, specificity of 89.5%.
Conclusions: Age, gender, rectus abdominis muscle thickness, and high early postoperative output are risk factors for SOO. A scoring model may be useful for predicting SOO. |
| format | Article |
| id | doaj-art-b579e902802a43c9a4f38b7d494f62ea |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-b579e902802a43c9a4f38b7d494f62ea2025-08-20T03:53:32ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-04-019226026910.23922/jarc.2024-1092024-109Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer SurgeryChiharu Yasui0Kyoichi Kihara1Ryo Ishiguro2Takuki Yagyu3Yusuke Kono4Manabu Yamamoto5Tomoyuki Matsunaga6Naruo Tokuyasu7Teruhisa Sakamoto8Yoshiyuki Fujiwara9Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori UniversityObjectives: In surgery for lower rectal cancer, temporary ileostomy can be created to avoid complications, such as anastomotic leakage. However, various complications may occur with the stoma, including stoma outlet obstruction (SOO). The occurrence of SOO can prolong the length of hospital stay and delay the introduction of adjuvant chemotherapy, which can negatively affect the prognosis. We retrospectively reviewed cases of temporary ileostomy at our hospital and evaluated the risk factors for SOO. Methods: We extracted data pertaining to patients with temporary ileostomy created during surgery for rectal cancer from 2013 to 2023, and compared clinicopathologic factors or short-term outcomes, with or without SOO complications. We scored the independent factors obtained and created predictive scoring model for SOO. Results: Total of 107 patients were included. SOO was observed in 21 patients (19.6%), all of whom were male. SOO was most frequently diagnosed on sixth postoperative day. In most cases, feeding resumed 4 days after the diagnosis of SOO. Age (67 years; p = 0.002), rectus abdominis muscle thickness (13.5 mm; p < 0.001) and the amount of stoma output greater than 1,500 ml/day within 3 days of surgery (p < 0.001) were independent risk factors for SOO. The preoperative and early postoperative predictive scoring model, created by adding one point to each risk factor, predicted SOO with sensitivity of 76.2%, specificity of 89.5%. Conclusions: Age, gender, rectus abdominis muscle thickness, and high early postoperative output are risk factors for SOO. A scoring model may be useful for predicting SOO.https://www.jstage.jst.go.jp/article/jarc/9/2/9_2024-109/_pdf/-char/enstoma outlet obstructionileostomyhigh-output stoma |
| spellingShingle | Chiharu Yasui Kyoichi Kihara Ryo Ishiguro Takuki Yagyu Yusuke Kono Manabu Yamamoto Tomoyuki Matsunaga Naruo Tokuyasu Teruhisa Sakamoto Yoshiyuki Fujiwara Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery Journal of the Anus, Rectum and Colon stoma outlet obstruction ileostomy high-output stoma |
| title | Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery |
| title_full | Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery |
| title_fullStr | Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery |
| title_full_unstemmed | Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery |
| title_short | Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery |
| title_sort | risk assessment of stoma outlet obstruction development when a temporary ileostomy is created during rectal cancer surgery |
| topic | stoma outlet obstruction ileostomy high-output stoma |
| url | https://www.jstage.jst.go.jp/article/jarc/9/2/9_2024-109/_pdf/-char/en |
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