BMC Surgery | |
Readmission after rectal resection in the ERAS-era: is a loop ileostomy the Achilles heel? | |
Albert M. Wolthuis1  André D’Hoore1  Gabriele Bislenghi1  Johanna Van Butsele1  | |
[1] Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium; | |
关键词: Rectal resection; Readmission; Ileostomy; Risk factors; ERAS; | |
DOI : 10.1186/s12893-021-01242-y | |
来源: Springer | |
【 摘 要 】
BackgroundRectal resection surgery is often followed by a loop ileostomy creation. Despite improvements in surgical technique and development of enhanced recovery after surgery (ERAS) protocols, the readmission-rate after rectal resection is still estimated to be around 30%. The purpose of this study was to identify risk factors for readmission after rectal resection surgery. This study also investigated whether elderly patients (≥ 65 years old) dispose of a distinct patient profile and associated risk factors for readmission.MethodsThis is a retrospective study of prospectively collected data from patients who consecutively underwent rectal resection for cancer within an ERAS protocol between 2011 and 2016. The primary study endpoint was 90-day readmission. Patients with and without readmission within 90 days were compared. Additional subgroup analysis was performed in patients ≥ 65 years old.ResultsA total of 344 patients were included, and 25% (n = 85) were readmitted. Main reasons for readmission were acute renal insufficiency (24%), small bowel obstruction (20%), anastomotic leakage (15%) and high output stoma (11%). In multivariate logistic regression, elevated initial creatinine level (cut-off values: 0.67–1.17 mg/dl) (OR 1.95, p = 0.041) and neoadjuvant radiotherapy (OR 2.63, p = 0.031) were significantly associated with readmission. For ileostomy related problems, elevated initial creatinine level (OR 2.76, p = 0.021) was identified to be significant.ConclusionRecovery after rectal resection within an ERAS protocol is hampered by the presence of a loop ileostomy. ERAS protocols should include stoma education and high output stoma prevention.
【 授权许可】
CC BY
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
RO202107070430977ZK.pdf | 801KB | download |