Risk factors for reoperation after ileostomy reversal - Results from a prospective cohort study

被引：16
作者：
Schneider, V. [1 ]
Lee, L. D. [1 ]
Stroux, A. [2 ]
Buhr, H. J. [3 ]
Ritz, J. P. [4 ]
Kreis, M. E. [1 ]
Lauscher, J. C. [1 ]
机构：
[1] Charie Campus Benjamin Franklin, Dept Gen Visceral & Vasc Surg, Hindenburgdamm 30, D-12200 Berlin, Germany
[2] Charite Campus Mitte, Inst Biometry & Clin Epidemiol, Charitepl 1, D-10098 Berlin, Germany
[3] German Soc Gen & Visceral Surg, Schiffbauerdamm 40, D-10117 Berlin, Germany
[4] HELIOS Kliniken Schwerin, Dept Gen & Visceral Surg, Wismarsche Str 393-397, D-19049 Schwerin, Germany
来源：
INTERNATIONAL JOURNAL OF SURGERY | 2016年 / 36卷
关键词：
Ileostomy closure; Operative revision; Risk factors; LOOP ILEOSTOMY; CLOSURE; MORBIDITY; COMPLICATIONS;
D O I：
10.1016/j.ijsu.2016.10.043
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Background: Ileostomy reversal is frequently performed in abdominal surgery. Postoperative complications after ileostomy reversal are encountered in around 20% of patients. Data regarding risk factors for reoperation after ileostomy closure are scarce. The purpose of this prospective trial was to determine risk factors for operative revision after ileostomy closure. Materials and methods: This is an additional post hoc analysis of a two center prospective trial. After enrollment, patient characteristics and intraoperative details were analyzed. Patients were followed up at one postoperative visit before discharge and at a three months postoperative visit by standardized questionnaire. All reoperations occurring in the three months period after surgery were analyzed, and immediate reoperations which were directly related to the ileostomy reversal were analyzed separately. Results: 118 patients with elective ileostomy reversal were included in the trial. 12 out of 106 patients (11.3%) underwent any reoperation within three months after surgery (Clavien-Dindo grade IIIb). On multivariate analysis, anemia was associated with any reoperation p = 0.004; OR 6.93 (95% CI 1.37 -30.07). Six out of 114 patients (5.3%) required an immediate reoperation (small bowel perforation, anastomotic leakage, postoperative ileus, deep wound infection) due to surgical complications directly related to the ileostomy reversal. Higher body mass index and anemia were associated with immediate reoperations (BMI: p = 0.038; OR 0.73 (95% CI 0.55-0.98); anemia: p = 0.001; OR 25.50 (95% CI 3.87 -168.21). Conclusion: Surgical complications after ileostomy reversal occurred to a substantial extent. Rate of reoperations was associated with anemia and high body mass index. Optimizing patients in terms of preoperative hemoglobin and BMI may reduce surgical complications after ileostomy closure. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码：233 / 239
页数：7
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