Predisposing factors for high-output stoma in patients with a prophylactic terminal ileostomy after radical resection of rectal cancer
10.3760/cma.j.cn115396-20240830-00269
- VernacularTitle:直肠癌术后预防性回肠造口高排量危险因素分析
- Author:
Qin LI
1
;
Fang FANG
;
Jun REN
;
Dongmei ZHENG
;
Dong TANG
Author Information
1. 江苏省苏北人民医院胃肠外科，扬州 225001
- Keywords:
Rectal neoplasms;
Ileostomy;
Risk factors;
High-output stoma
- From:
International Journal of Surgery
2024;51(9):622-627
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for high-output stoma (HOS) in patients undergoing rectal cancer radical resection combined with terminal ileostomy.Methods:A retrospective analysis was conducted on the medical records of 104 patients who underwent radical resection for rectal cancer combined with terminal ileostomy at Northern Jiangsu People′s Hospital from January 2020 to December 2022. Among them, 77 were male and 27 were female, with ages ranging from 31 to 84 years and an average age of 62.60 years. HOS was defined as an average stoma output ≥1500 mL/24 h within 3 days after resuming oral intake. Based on the presence of HOS post-surgery, patients were divided into the HOS group ( n=29) and the non-HOS group ( n=77). The two groups were compared based on gender, age, body mass index (BMI), preoperative albumin, hemoglobin, fasting blood glucose, surgery duration, surgical approach, intraoperative blood loss, postoperative albumin, hemoglobin, white blood cell count, and C-reactive protein (CRP). Data were analyzed using SPSS27.0. Continuous data were expressed as mean±standard deviation( ± s), and independent t-tests or non-parametric tests were used for group comparisons. Chi-square tests were used for categorical data, and logistic regression was employed to evaluate the influence of various factors on the occurrence of HOS. Results:There were no statistically significant differences between the two groups in terms of gender, preoperative albumin, hemoglobin, fasting blood glucose, surgery duration, surgical approach, intraoperative blood loss, postoperative albumin, hemoglobin, or white blood cell count ( P>0.05). Univariate logistic regression analysis indicated that older patients were more likely to develop HOS ( P=0.037, OR=1.047), those with lower BMI were at higher risk of HOS ( P<0.001, OR=0.448), and elevated postoperative CRP was associated with an increased likelihood of HOS ( P<0.001, OR=1.027). Multivariate logistic regression analysis showed that BMI ( OR=0.302, 95% CI: 0.164-0.555, P<0.001) and postoperative CRP ( OR=1.045, 95% CI: 1.023-1.068, P<0.001) were independent risk factors for the occurrence of HOS. Conclusion:Lower BMI and elevated postoperative CRP are significant independent risk factors for the development of HOS in rectal cancer patients.
