Complications associated with closure of defunctioning loop ileostomy in low anterior resection of rectal cancer
10.3760/cma.j.issn.1671-0274.2015.07.007
- VernacularTitle:直肠癌低位前切除保护性回肠造口还纳术后并发症分析
- Author:
Hongda PAN
1
;
Lin WANG
;
Yifan PENG
;
Jin GU
Author Information
1. 100142,北京大学肿瘤医院 北京肿瘤医院暨北京市肿瘤防治研究所结直肠肿瘤外科 恶性肿瘤发病机制及转化研究教育部重点实验室
- Keywords:
Rectal neoplasms;
Ileostomy;
closure technique;
Complication;
Surgical site infection;
Risk facor
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(7):656-660
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the complications of ileostomy closure and related risk factors. Methods Patients undergoing ileostomy closure in the Department of Colorectal Surgery, Peking University Cancer Hospital from September 2006 to March 2013 were included in this study. Clinical features of these patients were reviewed, the complications rate was calculated, and univariate and multivariate analyses with regard to the risk factors of surgical site infection (SSI) were also conducted. Results A total of 245 consecutive patients were enrolled in the study. Thirty-nine complications were observed in thirty-three patients, the overall complication rate was 13.5%. Complication after primary closure of defunctioning ileostomy included surgical site infection (n=21, 8.6%), ileus (n=8, 3.3%), preoperatively undiagnosed anastomotic leakage or rectovaginal fistula(n=5, 2.0%), pulmonary infection (n=2, 0.8%), and anal sphincter dysfunction (n=2, 0.8%). No patient died in the perioperative period, and 5 patients (2.0%) underwent reoperation for ileus (n=3), anastomotic leakage (n=1) andrectovaginal fistula (n=1). Multivariate analysis showed that postoperative complications [OR=10.576, 95%CI:2.898-38.597, P=0.000] and total operation time >90 min [OR=4.862, 95% CI:1.758-13.451, P=0.002] were independent risk factors of SSI, and the presence of subcutaneous vacuum drainage [OR=0.063, 95%CI:0.007-0.540, P=0.012] was protective factor of SSI. Conclusions Surgical site infection is the most common complication after primary closure of defunctioning ileostomy. Subcutaneous vacuum drainage is effective for reducing SSI in patients undergoing primary closure of ileostomy, and it is especially recommended for patients with operation time >90 min.
