Diverting loop ileostomy after restorative proctocolectomy

Predictors of poor outcome and poor quality of life

M. Scarpa, C. Ruffolo, R. Boetto, A. Pozza, L. Sadocchi, I. Angriman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Aim: Diverting loop ileostomy is used to minimize the impact of anastomotic complication after restorative proctocolectomy (RPC). However, the ileostomy itself may have complications and therefore affect quality of life (QOL). The aim of this study was to analyse the predictors of complications of the ileostomy formation and closure and of the QOL of these patients. Method: Forty-four consecutive patients who underwent RPC were enrolled. Records of the ileostomy follow-up were retrieved from a prospectively collected database and QOL was assessed with the Stoma-QOL questionnaire. Ileostomy site coordinates were measured. Univariate and multivariate analysis were performed. Results: In this series, three patients experienced peristomal herniae, two ileostomy stenosis, seven ileostomy retraction and fourteen peristomal dermatitis. Emergency surgery was the only predictor of parastomal hernia (P = 0.017). Stenosis correlated with the distance from the umbilicus (Τ = 0.24, P = 0.021). Use of standard rod and retraction were independent predictors of peristomal dermatitis (P = 0.049 and P = 0.001). Stoma-QOL was directly correlated to the age of the patients and to the occurrence of parastomal hernia (P = 0.001 and P = 0.021, respectively). After stoma closure, two patients reported wound sepsis and seven suffered obstructive episodes. Conclusion: The predictors of negative outcome after construction of a diverting loop ileostomy after RPC were urgent surgery, use of standard rod, the distance of the stoma site from the umbilicus, parastomal herniae and the older age of patients.

Original languageEnglish
Pages (from-to)914-920
Number of pages7
JournalColorectal Disease
Volume12
Issue number9
DOIs
Publication statusPublished - Sep 2010

Fingerprint

Restorative Proctocolectomy
Ileostomy
Quality of Life
Hernia
Umbilicus
Dermatitis
Pathologic Constriction
Sepsis
Emergencies
Multivariate Analysis
Databases

Keywords

  • Loop ileostomy
  • Quality of life
  • Restorative proctocolectomy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Diverting loop ileostomy after restorative proctocolectomy : Predictors of poor outcome and poor quality of life. / Scarpa, M.; Ruffolo, C.; Boetto, R.; Pozza, A.; Sadocchi, L.; Angriman, I.

In: Colorectal Disease, Vol. 12, No. 9, 09.2010, p. 914-920.

Research output: Contribution to journalArticle

Scarpa, M. ; Ruffolo, C. ; Boetto, R. ; Pozza, A. ; Sadocchi, L. ; Angriman, I. / Diverting loop ileostomy after restorative proctocolectomy : Predictors of poor outcome and poor quality of life. In: Colorectal Disease. 2010 ; Vol. 12, No. 9. pp. 914-920.
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AB - Aim: Diverting loop ileostomy is used to minimize the impact of anastomotic complication after restorative proctocolectomy (RPC). However, the ileostomy itself may have complications and therefore affect quality of life (QOL). The aim of this study was to analyse the predictors of complications of the ileostomy formation and closure and of the QOL of these patients. Method: Forty-four consecutive patients who underwent RPC were enrolled. Records of the ileostomy follow-up were retrieved from a prospectively collected database and QOL was assessed with the Stoma-QOL questionnaire. Ileostomy site coordinates were measured. Univariate and multivariate analysis were performed. Results: In this series, three patients experienced peristomal herniae, two ileostomy stenosis, seven ileostomy retraction and fourteen peristomal dermatitis. Emergency surgery was the only predictor of parastomal hernia (P = 0.017). Stenosis correlated with the distance from the umbilicus (Τ = 0.24, P = 0.021). Use of standard rod and retraction were independent predictors of peristomal dermatitis (P = 0.049 and P = 0.001). Stoma-QOL was directly correlated to the age of the patients and to the occurrence of parastomal hernia (P = 0.001 and P = 0.021, respectively). After stoma closure, two patients reported wound sepsis and seven suffered obstructive episodes. Conclusion: The predictors of negative outcome after construction of a diverting loop ileostomy after RPC were urgent surgery, use of standard rod, the distance of the stoma site from the umbilicus, parastomal herniae and the older age of patients.

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