Risk factors for postoperative stoma outlet obstruction in ulcerative colitis

doi:10.4240/wjgs.v12.i12.507

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 12, Issue 12

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (8883)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Tables (1-8) series.

Item

Count

PDF

383

WORD

171

HTML

3337

Tables (1-8)

912

Sum=4803

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

408

Download

1241

Sum=1649

Publishing Process of This Article

Item

Count

Browse

669

Download

1667

Sum=2336

Dec 27, 2020 (publication date) through Feb 18, 2026

Times Cited of This Article

Times Cited (10)

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Dec 27, 2020; 12(12): 507-519
Published online Dec 27, 2020. doi: 10.4240/wjgs.v12.i12.507

Risk factors for postoperative stoma outlet obstruction in ulcerative colitis

Tomoaki Kitahara, Yu Sato, Takashi Oshiro, Rie Matsunaga, Makoto Nagashima, Shinichi Okazumi

Tomoaki Kitahara, Yu Sato, Takashi Oshiro, Rie Matsunaga, Makoto Nagashima, Shinichi Okazumi, Department of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan

Author contributions: Kitahara T designed and performed the research and wrote the paper; Sato Y and Matsunaga R designed the research and contributed to the analysis; Oshiro T, Nagashima M, and Okazumi S provided clinical advice and supervised the report; and all authors have approved the final version of the article to be published.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Toho University Sakura Medical Center (IRB approval code: S19026, Toho University Sakura Medical Center).

Informed consent statement: Patients were not required to give informed consent in order to be included in the study because the analysis used anonymous clinical data that were obtained after each patient had agreed to treatment by written consent. The details of the study were published on the home page of Toho University Sakura Medical Center.

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Data sharing statement: No additional data are available.

Corresponding author: Yu Sato, MD, Lecturer, Department of Surgery, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura 285-8741, Chiba, Japan. yu.sato@med.toho-u.ac.jp

Received: August 3, 2020
Peer-review started: August 3, 2020
First decision: September 17, 2020
Revised: September 28, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: December 27, 2020
Processing time: 140 Days and 6.8 Hours

ARTICLE HIGHLIGHTS

Research background

The standard procedure for ulcerative colitis (UC) is restorative proctocolectomy with ileal pouch-anal anastomosis, and it is common to perform two- or three-stage restorative proctocolectomy with diverting ileostomy.

Research motivation

Stoma outlet obstruction (SOO) often occurs after surgery for UC but its causes are not well known.

Research objectives

To identify the risk factors for SOO after stoma surgery in patients with UC.

Research methods

A retrospective study of 148 UC patients. Univariate and multivariate analyses were performed to identify risk factors for SOO and recurring SOO.

Research results

SOO occurred in 25 (16.9%) patients. In the multivariate analysis, loop ileostomy (OR = 6.361; 95%CI 1.322-30.611; P = 0.021) and maximum stoma drainage volume (OR = 1.000; 95%CI 1.000-1.001; P = 0.015) were found to be independent risk factors for SOO. Among the 25 patients with SOO, seven (28.0%) patients repeatedly developed SOO during the period of observation. Rectus abdominis muscle thickness was an independent risk factor for recurring SOO (OR = 2.676; 95%CI 1.176-4.300; P = 0.008).

Research conclusions

High maximum stoma drainage volume and loop ileostomy were independent risk factors for SOO in this study. In patients with a thick rectus abdominis muscle, the risk of SOO recurrence is high.

Research perspectives

Surgeons should be aware of the importance of fluid management and careful selection of the stoma position in patients with thick rectus abdominis muscles to prevent SOO recurrence. Alternative surgical procedures that can avoid loop ileostomy are required.