Cargando…
Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies
BACKGROUND: Temporary defunctioning ileostomy can reduce the consequences of anastomotic leak following low anterior resection. However, some patients never have their ileostomy reversed and in other cases the time to reversal of ileostomy can be delayed. The aim of this study was to identify the il...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522985/ https://www.ncbi.nlm.nih.gov/pubmed/26251682 http://dx.doi.org/10.14740/jocmr2150w |
_version_ | 1782384022045851648 |
---|---|
author | Waterland, Peter Goonetilleke, Kolitha Naumann, David N. Sutcliff, Mathew Soliman, Faris |
author_facet | Waterland, Peter Goonetilleke, Kolitha Naumann, David N. Sutcliff, Mathew Soliman, Faris |
author_sort | Waterland, Peter |
collection | PubMed |
description | BACKGROUND: Temporary defunctioning ileostomy can reduce the consequences of anastomotic leak following low anterior resection. However, some patients never have their ileostomy reversed and in other cases the time to reversal of ileostomy can be delayed. The aim of this study was to identify the ileostomy closure rate following anterior resection, time to closure of ileostomy, reasons for delay in reversal and whether delay was associated with an increased complication rate. METHODS: Data were collected retrospectively on consecutive patients undergoing defunctioning ileostomy following anterior resection for rectal cancer, between January 2009 and August 2013. Data were collected on reversal of ileostomy rates, time to reversal, reasons for delayed reversal (defined as > 6 months) and complications following reversal. RESULTS: One hundred seventy patients were studied (median age 69 years, range 41 - 90 years), of whom 117 (69%) were male. One hundred twenty-seven (75%) patients had their ileostomies reversed. Median time to reversal was 6 months (range 1 - 42). In 63 patients who had delayed reversal, reasons were adjuvant chemotherapy (22, 35%), medical illness (14, 22%), anastomotic leak (9, 14%), and others (4, 7%). Postoperative complications occurred in 33 patients (26%). There was no postoperative mortality. Univariate analysis showed that delayed reversal was associated with an increased rate of complications and longer length of hospital stay following reversal (P < 0.05). CONCLUSIONS: One in four defunctioning ileostomies are not closed following anterior resection in our unit. Of those that are closed, approximately 50% have delayed closure beyond 6 months which is associated with increased risk of complications following their ileostomy reversal. |
format | Online Article Text |
id | pubmed-4522985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-45229852015-08-06 Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies Waterland, Peter Goonetilleke, Kolitha Naumann, David N. Sutcliff, Mathew Soliman, Faris J Clin Med Res Original Article BACKGROUND: Temporary defunctioning ileostomy can reduce the consequences of anastomotic leak following low anterior resection. However, some patients never have their ileostomy reversed and in other cases the time to reversal of ileostomy can be delayed. The aim of this study was to identify the ileostomy closure rate following anterior resection, time to closure of ileostomy, reasons for delay in reversal and whether delay was associated with an increased complication rate. METHODS: Data were collected retrospectively on consecutive patients undergoing defunctioning ileostomy following anterior resection for rectal cancer, between January 2009 and August 2013. Data were collected on reversal of ileostomy rates, time to reversal, reasons for delayed reversal (defined as > 6 months) and complications following reversal. RESULTS: One hundred seventy patients were studied (median age 69 years, range 41 - 90 years), of whom 117 (69%) were male. One hundred twenty-seven (75%) patients had their ileostomies reversed. Median time to reversal was 6 months (range 1 - 42). In 63 patients who had delayed reversal, reasons were adjuvant chemotherapy (22, 35%), medical illness (14, 22%), anastomotic leak (9, 14%), and others (4, 7%). Postoperative complications occurred in 33 patients (26%). There was no postoperative mortality. Univariate analysis showed that delayed reversal was associated with an increased rate of complications and longer length of hospital stay following reversal (P < 0.05). CONCLUSIONS: One in four defunctioning ileostomies are not closed following anterior resection in our unit. Of those that are closed, approximately 50% have delayed closure beyond 6 months which is associated with increased risk of complications following their ileostomy reversal. Elmer Press 2015-09 2015-07-24 /pmc/articles/PMC4522985/ /pubmed/26251682 http://dx.doi.org/10.14740/jocmr2150w Text en Copyright 2015, Waterland et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Waterland, Peter Goonetilleke, Kolitha Naumann, David N. Sutcliff, Mathew Soliman, Faris Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title | Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title_full | Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title_fullStr | Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title_full_unstemmed | Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title_short | Defunctioning Ileostomy Reversal Rates and Reasons for Delayed Reversal: Does Delay Impact on Complications of Ileostomy Reversal? A Study of 170 Defunctioning Ileostomies |
title_sort | defunctioning ileostomy reversal rates and reasons for delayed reversal: does delay impact on complications of ileostomy reversal? a study of 170 defunctioning ileostomies |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522985/ https://www.ncbi.nlm.nih.gov/pubmed/26251682 http://dx.doi.org/10.14740/jocmr2150w |
work_keys_str_mv | AT waterlandpeter defunctioningileostomyreversalratesandreasonsfordelayedreversaldoesdelayimpactoncomplicationsofileostomyreversalastudyof170defunctioningileostomies AT goonetillekekolitha defunctioningileostomyreversalratesandreasonsfordelayedreversaldoesdelayimpactoncomplicationsofileostomyreversalastudyof170defunctioningileostomies AT naumanndavidn defunctioningileostomyreversalratesandreasonsfordelayedreversaldoesdelayimpactoncomplicationsofileostomyreversalastudyof170defunctioningileostomies AT sutcliffmathew defunctioningileostomyreversalratesandreasonsfordelayedreversaldoesdelayimpactoncomplicationsofileostomyreversalastudyof170defunctioningileostomies AT solimanfaris defunctioningileostomyreversalratesandreasonsfordelayedreversaldoesdelayimpactoncomplicationsofileostomyreversalastudyof170defunctioningileostomies |