Complications of Diverting Ileostomy after Low Anterior Resection for Rectal Carcinoma.
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| Abstract |
There have been few studies directly comparing the postoperative complications in patients with a diverting ileostomy to patients who were not diverted after low anterior resection (LAR) for rectal carcinoma. This study is a retrospective chart review of all rectal carcinoma patients (99) who underwent a LAR from January 2009 to December 2014 at Loma Linda University Medical Center and Veterans Affairs Loma Linda Healthcare System. A majority of patients were diverted (58% vs 42%). The diverted patients were more likely to have a low tumor location (P < 0.01), preoperative chemoradiation (P < 0.01), and more intraoperative blood loss (P < 0.01). Our study shows a statistically significant higher overall complication rate among patients receiving a diverting ileostomy in the six months after LAR (61% vs 38%, P = 0.02). The difference is due to a higher rate of readmission (27% vs 14%) and acute kidney injury (14% vs 5%) in patients with a diverting ileostomy. It also shows that there is a higher rate of unplanned reoperation (11% vs 6%) due to anastomotic leak (17% vs 5%) in nondiverted patients. Further studies are needed to refine the specific indications to maximize the benefit of diverting ileostomy after LAR for rectal carcinoma.
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| Authors | Sean Maroney, Carlos Chavez de Paz, Marjunphilip Duldulao, Tracey Kim, Mark E Reeves, Kevork K Kazanjian, Naveenraj Solomon, Carlos Garberoglio |
| Journal | The American surgeon (Am Surg) Vol. 82 Issue 10 Pg. 1033-1037 (Oct 2016) ISSN: 1555-9823 [Electronic] United States |
| PMID | 27780000 (Publication Type: Comparative Study, Journal Article) |
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