TY - JOUR
T1 - Clinical Characteristics of Stoma-Related Obstruction after Ileal Pouch–Anal Anastomosis for Ulcerative Colitis
AU - Okita, Yoshiki
AU - Araki, Toshimitsu
AU - Kondo, Satoru
AU - Fujikawa, Hiroyuki
AU - Yoshiyama, Shigeyuki
AU - Hiro, Junichiro
AU - Inoue, Mikihiro
AU - Toiyama, Yuji
AU - Kobayashi, Minako
AU - Ohi, Masaki
AU - Inoue, Yasuhiro
AU - Uchida, Keiichi
AU - Mohri, Yasuhiko
AU - Kusunoki, Masato
N1 - Publisher Copyright:
© 2016, The Society for Surgery of the Alimentary Tract.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Aims: We defined small bowel obstruction occurring around the limbs of the ileostomy as stoma-related obstruction (SRO) and investigated the clinical characteristics and predictive factors of SRO. Methods: From January 2002 to March 2016, 309 consecutive patients who underwent ileal pouch–anal anastomosis (IPAA) for ulcerative colitis were enrolled. Two-stage IPAA with diverting ileostomy was analyzed. We assessed the possible associations between SRO and clinical factors. Results: A total of 205 patients met the inclusion criteria. Fifty-three (25.8%) patients with SRO before ileostomy closure were identified for review. All patients with SRO were at least transiently resolved by intubation though orifice of ileostomy (98.1%) or nasally (3.7%). In 18 (33.9%) patients, the ileostomy was taken down ahead of schedule and the small bowel obstruction improved in all cases. Multivariate analysis revealed that age at surgery <16 years old and body mass index <21 were significant predictive factors for SRO (P = 0.013 and 0.0012, respectively). Conclusion: Younger age at surgery and low body mass index may be significant predictive factors for SRO after IPAA with diverting ileostomy in patients with ulcerative colitis.
AB - Aims: We defined small bowel obstruction occurring around the limbs of the ileostomy as stoma-related obstruction (SRO) and investigated the clinical characteristics and predictive factors of SRO. Methods: From January 2002 to March 2016, 309 consecutive patients who underwent ileal pouch–anal anastomosis (IPAA) for ulcerative colitis were enrolled. Two-stage IPAA with diverting ileostomy was analyzed. We assessed the possible associations between SRO and clinical factors. Results: A total of 205 patients met the inclusion criteria. Fifty-three (25.8%) patients with SRO before ileostomy closure were identified for review. All patients with SRO were at least transiently resolved by intubation though orifice of ileostomy (98.1%) or nasally (3.7%). In 18 (33.9%) patients, the ileostomy was taken down ahead of schedule and the small bowel obstruction improved in all cases. Multivariate analysis revealed that age at surgery <16 years old and body mass index <21 were significant predictive factors for SRO (P = 0.013 and 0.0012, respectively). Conclusion: Younger age at surgery and low body mass index may be significant predictive factors for SRO after IPAA with diverting ileostomy in patients with ulcerative colitis.
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U2 - 10.1007/s11605-016-3329-2
DO - 10.1007/s11605-016-3329-2
M3 - Article
C2 - 27896653
AN - SCOPUS:84997831631
SN - 1091-255X
VL - 21
SP - 554
EP - 559
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 3
ER -