Morbidity of Diverting Ileostomy for Rectal Cancer: Analysis of the American College of Surgeons National Surgical Quality Improvement Program
| Autor: | Joseph C. Carmichael, Fariba Jafari, Steven Mills, Mehraneh D. Jafari, Vinh Q. Nguyen, Alessio Pigazzi, Wissam J. Halabi, Michael J. Stamos |
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| Rok vydání: | 2013 |
| Předmět: |
Reoperation
Male medicine.medical_specialty Demographics Colorectal cancer Clinical Sciences Databases Postoperative Complications Clinical Research Weight loss medicine Humans Factual Retrospective Studies Aged Cancer Rectal Neoplasms Ileostomy business.industry Prevention Significant difference General Medicine Length of Stay Middle Aged medicine.disease Quality Improvement United States Surgery Acs nsqip Diverting ileostomy Treatment Outcome Logistic Models Increased risk Steroid use Multivariate Analysis Linear Models Female medicine.symptom business |
| Zdroj: | Jafari, MD; Halabi, WJ; Jafari, F; Nguyen, VQ; Stamos, MJ; Carmichael, JC; et al.(2013). Morbidity of diverting ileostomy for rectal cancer: Analysis of the American College of Surgeons National Surgical Quality Improvement Program. American Surgeon, 79(10), 1034-1039. UC Irvine: Retrieved from: http://www.escholarship.org/uc/item/6z2347bx Scopus-Elsevier The American surgeon, vol 79, iss 10 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481307901016 |
| Popis: | There is controversy regarding the potential benefits of diverting ileostomy after low anterior resection (LAR). This study aims to examine the morbidity associated with diverting ileostomy in rectal cancer. A retrospective review of LAR cases was performed using the American College of Surgeons National Surgical Quality Improvement Program (2005 to 2011). Patients who underwent LAR with and without diversion were selected. Demographics, intraoperative events, and postoperative complications were reviewed. Among the 6337 cases sampled, 991 (16%) received a diverting ileostomy. Patients who were diverted were younger (60 vs 63 years), predominantly male (64 vs 53%), and more likely to have received pre-operative radiation (39 vs 12%). There was no significant difference in steroid use, weight loss, or intraoperative transfusion. Postoperatively, there was no significant difference in length of stay, rate of septic complications, wound infections, and mortality. The rate of reoperation was lower in the diverted group (4.5 vs 6.9%). Diversion was associated with a higher risk-adjusted rate of acute renal failure (OR 2.4; 95% CI (1.2, 4.6); P |
| Databáze: | OpenAIRE |
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