Background: Fluid and electrolyte disturbance, which impairs renal function, has been reported in patients with temporary ileostomy. However, the dynamic changes in serum electrolytes and renal function in rectal cancer patients with ileostomy have not been well described. In the present study, we aimed to evaluate alterations in serum electrolytes and renal function in rectal cancer patients undergoing ileostomy creation and closure. Methods: The levels of serum potassium, serum sodium, serum blood urea nitrogen, serum creatinine and estimated glomerular filtration rate (eGFR) were analyzed in 320 patients with rectal cancer including 156 patients with an ileostomy (the ileostomy group) and 164 patients without an ileostomy (the control group). Results: After index surgery, the levels of serum potassium and serum creatinine in the ileostomy group were significantly higher than those in the control group (P<0.05). In contrast, the levels of serum sodium and the eGFR showed decreases in the ileostomy group compared to the control group after index surgery (P<0.05). At 3 months after ileostomy creation, the ileostomy group had a significantly increased rate of eGFR <60 mL/min/1.73 m 2 compared to the control group (5.8% vs. 1.2%, P=0.032). In line with the results of univariate analysis, multivariable analysis identified ileostomy and diabetes as independent risk factors for a decreased eGFR (P=0.005 and P=0.022, respectively). Furthermore, a significantly rebound of eGFR was observed in patients after ileostomy closure (P=0.013). Conclusions: Ileostomy can cause temporary electrolyte disturbance and renal function impairment in patients with rectal cancer. Diabetes is an independent risk factor for renal function damage in patients with rectal cancer who receive a temporary ileostomy.

Background: Gastric schwannoma (GS) was a rare mesenchymal tumor that was difficult to distinguish from a non-metastatic gastric stromal tumor (GST). The nomogram constructed by CT features had an advantage in the differential diagnosis of gastric malignant tumors. Therefore, we conducted a retrospective analysis of their respective computed tomography (CT) features. Methods: We conducted a retrospective single-institution review of resected GS and non-metastatic GST between January 2017 and December 2020. Patients who were pathologically confirmed after surgery and underwent CT within two weeks before surgery were selected. The exclusion criteria were as follows: incomplete clinical data; CT images that were incomplete or of poor quality. A binary logistic regression model was built for analysis. Through univariate and multivariate analysis, CT image features were evaluated to determine the significant differences between GS and GST. Results: The study population comprised 203 consecutive patients (29 with GS and 174 with GST). There were significant differences in gender distribution (P=0.042) and symptoms (P=0.002). Besides, GST tended to involve the presence of necrosis (P=0.003) and lymph nodes (P=0.003). The area under the curve (AUC) value of unenhanced CT (CTU) was 0.708 [95% confidence interval (CI): 62.10–79.56%], the AUC value of venous phase CT (CTP) was 0.774 (95% CI: 69.45–85.34%), and the AUC value of venous phase enhancement (CTPU) was 0.745 (95% CI: 65.87–83.06%). CTP was the most specific feature, with a sensitivity of 83% and a specificity of 66%. The ratio of long diameter to short diameter (LD/SD) was significantly different (P=0.003). The AUC of the binary logistic regression model was 0.904. Multivariate analysis showed that necrosis and LD/SD were independent factors affecting the identification of GS and GST. Conclusions: LD/SD was a novel distinguishing feature between GS and non-metastatic GST. In conjunction with CTP, LD/SD, location, growth pattern, necrosis, and lymph node, a nomogram was constructed to predict.