Predictors of complications after prophylactic ileostomy reversal for rectal cancer: A retrospective study

作者全名：Lv, Quan; Shu, Xin-Peng; Peng, Dong; Li, Si-Qi; Xiang, Zheng

作者地址：[Lv, Quan; Shu, Xin-Peng; Peng, Dong; Li, Si-Qi; Xiang, Zheng] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, 1 Youyi Roud, Chongqing 400016, Peoples R China; [Xiang, Zheng] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Dept Gen Surg, Chongqing 400016, Peoples R China

通信作者：Xiang, Z (通讯作者)，Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, 1 Youyi Roud, Chongqing 400016, Peoples R China.

来源：WORLD JOURNAL OF GASTROINTESTINAL SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001237308800013

JCR分区：Q2

影响因子：1.8

年份：2024

卷号：16

期号：5

开始页：　

结束页：　

文献类型：Article

关键词：Ileostomy; Reversal; Risk factors; Complications; Rectal cancer

摘要：BACKGROUND Previous studies have analyzed the risk factors for complications after ileostomy reversal for rectal cancer (RC), but there were significant differences in the reported risk factors for complications after stoma reversal. No studies have analyzed the risk factors for stoma-related complications and overall postoperative complications separately. AIM To analyze the risk factors for overall complications and stoma-related complications after ileostomy reversal for patients with RC. METHODS This was a retrospective study of 439 patients who underwent ileostomy reversal at a clinical center and were followed up between September 2012 and September 2022. Continuous variables are expressed as the mean +/- SD and were analyzed with independent-sample t tests, while frequency variables are expressed as n (%), and the chi(2) test or Fisher's exact test was used. Univariate and multivariate logistic regression analyses were used to identify predictors of overall complications and stoma-related complications. RESULTS The overall complication rate after ileostomy reversal was 11.4%. Patients with lower preoperative albumin concentration (P < 0.01), greater blood loss (P = 0.017), and longer operative times (P < 0.01) were more likely to experience postoperative complications. The incidence of stoma-related complications was 6.4%. Analysis of the study showed that a higher body mass index (BMI) (P < 0.01), preoperative comorbid hypertension (P = 0.049), time from primary surgery to ileostomy reversal (P < 0.01) and longer operation time (P = 0.010) were more likely to result in stoma-related complications postoperatively. Multivariate logistic regression analysis revealed that a lower preoperative albumin level (P < 0.01, OR = 0.888, 95%CI: 0.828-0.958) was an independent risk factor for overall complications. Moreover, multivariate analysis revealed that BMI (P < 0.01, OR = 1.176, 95%CI: 1.041-1.330) and time from primary surgery to ileostomy reversal (P < 0.01, OR = 1.140, 95%CI: 1.038-1.252) were independent risk factors for stoma-related complications after stoma reversal. CONCLUSION The preoperative albumin level was a predictor of overall complications. Preoperative BMI and the time from primary surgery to ileostomy reversal were predictors of stoma-related complications.

基金机构：Science and Technology Planning Project of Yuzhong District of Chongqing City [20210115]

基金资助正文：Science and Technology Planning Project of Yuzhong District of Chongqing City, No. 20210115.