Risk factors for developing high-output ileostomy in CRC patients: a retrospective study

Abstract Background Anastomotic leakage is one of the most serious postoperative complications of rectal cancer. Prophylactic ileostomy has been widely used to reduce the risk and severity of complications of anastomotic leakage. However, prophylactic ileostomy itself has some complications, and ileostomy high output syndrome (HOS) is one of them. This study was performed to explore the risk factors of HOS in ileostomy. Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last 5 years. The relationship between HOS and the clinicopathological data was analyzed using the Chi-square test and Fisher’s exact probability. Multivariate analysis was performed by logistic regression. Results The incidence of HOS was 23.07% in this study. Dehydration was the most common symptom of HOS (37.7%). There was no clear correlation between HOS occurrence with sex, age, gross typing, histological grade, tumor location, lymph node metastasis, and TNM stage (p > 0.05). The incidence of HOS was 14/18 in inflammatory bowel disease patients, 18/28 in diabetes mellitus patients, and 23/72 in neoadjuvant chemoradiotherapy patients, 13/17 in total colectomy and abdominal infection patients. Multivariate analysis showed that they are risk factors for HOS (p < 0.05). Conclusion HOS occurred occasionally but rarely studied and lacks attention. Inflammatory bowel disease, diabetes mellitus, neoadjuvant radiotherapy chemotherapy, total colectomy and abdominal infection are the risk factors for HOS.

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Risk factors for developing high-output ileostomy: a retrospective study

10.21203/rs.3.rs-22014/v2 ◽

2021 ◽

Author(s):

Xiao Jian'an ◽

Dongxiao Bai ◽

Lei Li ◽

Zhiling Shen ◽

Tianchen Huang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Total Colectomy ◽

Neoadjuvant Chemoradiotherapy ◽

Clear Correlation ◽

Abdominal Infection ◽

Inflammatory Bowel

Abstract Background Prophylactic ileostomy and colostomy have been widely used to reduce the risk and complications of anastomotic leakage with high-risk colorectal cancer after operation. However, prophylactic ileostomy itself has some complications, and ileostomy high out-put syndrome is one of them. This study was performed to explore the risk factors of HOS in ileostomy.Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last five years. The clinical and pathological data were analyzed. The relationship between HOS and clinicopathological data was analyzed. Multivariate analysis was performed by logistic regression.Results There was no clear correlation between the occurrence of HOS with sex, age, gross typing, histological grade, location of tumors, lymph node metastasis and TNM stage (p>0.05). Preoperative complications including inflammatory bowel disease, diabetes mellitus and neoadjuvant chemoradiotherapy were risk factors for HOS (p<0.05). Total colectomy and abdominal infection were risk factors for HOS (p<0.05) during operation.Conclusion Inflammatory bowel disease, diabetes mellitus and neoadjuvant radiotherapy and chemotherapy in patients with colorectal cancer are the preoperative risk factors for HOS. Total colectomy and postoperative abdominal infection are the postoperative risk factors for HOS.

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Risk factors for developing high-output ileostomy: a retrospective study

10.21203/rs.3.rs-22014/v1 ◽

2020 ◽

Author(s):

Xiao Jian'an ◽

Dongxiao Bai ◽

Lei Li ◽

Zhiling Shen ◽

Tianchen Huang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Total Colectomy ◽

Neoadjuvant Chemoradiotherapy ◽

Clear Correlation ◽

Abdominal Infection ◽

Inflammatory Bowel

Abstract Background: Prophylactic ileostomy and colostomy have been widely used to reduce the risk and complications of anastomotic leakage with high-risk colorectal cancer after operation. However, prophylactic ileostomy itself has some complications, and ileostomy high out-put syndrome is one of them. This study was performed to explore the risk factors of HOS in ileostomy.Methods: A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last five years. The clinical and pathological data were analyzed. The relationship between HOS and clinicopathological data was analyzed. Multivariate analysis was performed by logistic regression.Results: There was no clear correlation between the occurrence of HOS with sex, age, gross typing, histological grade, location of tumors, lymph node metastasis and TNM stage (p > 0.05). Preoperative complications including inflammatory bowel disease, diabetes mellitus and neoadjuvant chemoradiotherapy were risk factors for HOS (p < 0.05). Total colectomy and abdominal infection were risk factors for HOS (p < 0.05) during operation.Conclusion: Inflammatory bowel disease, diabetes mellitus and neoadjuvant radiotherapy and chemotherapy in patients with colorectal cancer are the preoperative risk factors for HOS. Total colectomy and postoperative abdominal infection are the postoperative risk factors for HOS.

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Clostridioides difficile Enteritis in Patients Following Total Colectomy—a Rare but Genuine Clinical Entity

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz409 ◽

2019 ◽

Vol 6 (11) ◽

Author(s):

Robert J Ulrich ◽

Jonathan Bott ◽

Hannah Imlay ◽

Kerri Lopez ◽

Sandro Cinti ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Total Colectomy ◽

Severe Disease ◽

Clinical Entity ◽

Acid Suppression ◽

Clostridioides Difficile ◽

Inflammatory Bowel ◽

One Year

Clostridioides difficile enteritis (CDE) after colectomy is an understudied infectious syndrome. We reviewed 20 years of post-colectomy data and found CDE in 44/855 (5.1%) patients, usually within one year of surgery. Risk factors include acid suppression, inflammatory bowel disease, and antibiotics with enteral feeds. Clostridioides difficile enteritis often presents with severe disease requiring hospitalization.

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Risk Factors for Small Bowel Obstruction After Laparoscopic Ileal Pouch–Anal Anastomosis for Inflammatory Bowel Disease: A Multivariate Analysis in Four Expert Centres in Europe

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjy160 ◽

2018 ◽

Vol 13 (3) ◽

pp. 294-301 ◽

Cited By ~ 4

Author(s):

D Mege ◽

F Colombo ◽

M E Stellingwerf ◽

A Germain ◽

L Maggiori ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Multivariate Analysis ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Disease ◽

Ileal Pouch ◽

Anal Anastomosis ◽

Inflammatory Bowel

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A Multicentre Evaluation of Risk Factors for Anastomotic Leakage After Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis for Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjv170 ◽

2015 ◽

Vol 10 (7) ◽

pp. 773-778 ◽

Cited By ~ 30

Author(s):

Saloomeh Sahami ◽

Sanne A. L. Bartels ◽

André D’Hoore ◽

Tonia Young Fadok ◽

Pieter J. Tanis ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Anastomotic Leakage ◽

Restorative Proctocolectomy ◽

Bowel Disease ◽

Ileal Pouch ◽

Ileal Pouch Anal Anastomosis ◽

Anal Anastomosis ◽

Inflammatory Bowel

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INCIDENCE AND RISK FACTORS FOR NEOPLASIA IN INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.105 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S43-S43

Author(s):

Joana Lemos Garcia ◽

Isadora Rosa ◽

Joana Moleiro ◽

João Pereira da Silva ◽

António Dias Pereira

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Multivariate Analysis ◽

Bowel Disease ◽

Remission Rate ◽

Statistical Significance ◽

Univariate Analysis ◽

Tobacco Exposure ◽

Increased Risk ◽

Inflammatory Bowel

Abstract Introduction and goals Inflammatory Bowel Disease (IBD) patients may have an increased risk of neoplasia due to IBD itself or its therapy. The aim of this study was to evaluate the incidence of malignant neoplasia in IBD patients in a portuguese hospital, the associated risk factors and the therapy adjustments made. Methods Unicentric retrospective cohort study. All patients followed for IBD in a tertiary portuguese hospital and oncological center during 2015–2020 were included. Demographic and clinical data were registered. Results A total of 318 patients were included: female n=175(55.0%), age at diagnosis=37.24(±15,28)years-old, Crohn’s disease (CD) n=168(52.8%), Primary Sclerosing Cholangitis n=7, family history of cancer n=12, previous diagnosis of neoplasia n=23(7.2%), smokers n=49 (15.4%). A total of 42 cancers were diagnosed in 36 patients (11.3%) - median of 12.0(IQR=8.0–21.0) years after IBD diagnosis. Most affected organs: skin (n=15 in 11 patients; melanoma=1), colon and rectum (n=8 in 6 patients), prostate (n=4), breast (n=3) and anal canal (n=2). In those with non-melanoma skin cancer, 6 patients were under active treatment with azathioprine and 2 had stopped it for more than two years. In both univariate/multivariate analysis, the occurrence of neoplasia was associated with tobacco exposure (p=0.0.29/p=0.004), age (p<0.001/p=0,003) and IBD duration (p=0.001/p=0.017). There was no association with IBD therapy. In 9 cases, the cancer treatment was different because of the IBD (type of surgery n=6, drugs used n=2, radiotherapy not used n=1); IBD treatment was changed in 9 patients; clinical remission was lost in 1 patient in whom azathioprine treatment was halted after cancer. In the last follow-up, 3 patients remained with active oncological disease and 5 had died, 3 of which with active cancer. In those affected by cancer, in the univariate analysis, its cure/remission was negatively associated with tobacco exposure (p=0.003) and positively with salicylates use (p=0.016) and IBD remission before cancer diagnosis (p=0.008). In the multivariate analysis, the statistical significance was lost. Overall survival was lower in smokers with or without neoplasia (p<0.001) and in those who developped cancer (p=0.003). Conclusion In IBD patients, cancer mostly affected the skin and the lower digestive system. As in the general population, age and tobacco exposure were risk factors for the development of neoplasia. Tobacco is globally associated with lower survival rates and may be associated with a lower cure/remission rate, while salicylates and IBD remission may have a beneficial effect.

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