Low Level of Albumin and Longer Interval to Closure Time Increase the Morbidities in Ileostomy Closure; A Cohort Study of 354 Consecutive Patients

HyungJoo Baik1 and Ki Beom Bae1,2*

1Department of Surgery, Inje University, Korea
2Paik Institute for Clinical Research, Inje University, Korea

^*Correspondance to: Ki Beom Bae 

 PDF  Full Text DOI: 10.25107/2474-1647.2838

Abstract

Introduction: Temporary diverting ileostomy has an important role of mitigating the serious effects of anastomotic leakage in colorectal surgery. However, morbidity and mortality of ileostomy reversal cannot be overlooked. We investigated the possible risk factors for complications following ileostomy reversal. Methods: All the patients who underwent loop ileostomy closure between 2008 and 2017 at Inje University Busan Paik Hospital were identified. Medical records on patient characteristics, preoperative managements, surgical techniques, postoperative managements, chemotherapy/ radiotherapy and complications were retrospectively analyzed in the prospectively collected database. Results: Three hundred fifty-four underwent loop ileostomy closure. The overall complication rate was 23.7% with Clavien-Dindo grade I being the most common (15.8%), 5.6% in grade II, 2.2% in grade III-V, and three patients died. The two most common complications were wound infection (11.6%) and small bowel obstruction (4.8%). In univariable and multivariable analysis, closure technique or chemotherapy did not affect the outcome, but low serum albumin <3.5 g/dL (OR 7.248, CI 2.416–22.838, p<0.001) and longer interval to ileostomy closure (OR 1.977, CI 1.167–3.350, p=0.0113) were independent contributing factors for morbidities of ileostomy closure. Conclusions: Closure technique or chemotherapy did not affect the complication of ileostomy closure. However, serum albumin <3.5 g/dL and longer interval to ileostomy closure were identified as the risk factor for morbidity of ileostomy closure. These two factors should be corrected and planned before ileostomy closure.

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Cite the article

Baik HJ, Bae KB. Low Level of Albumin and Longer Interval to Closure Time Increase the Morbidities in Ileostomy Closure; a Cohort Study of 354 Consecutive Patients. Clin Surg. 2020; 5: 2838.