Impact of the Diverting Stoma on Renal Function.

Journal

Diseases of the colon and rectum
ISSN: 1530-0358
Titre abrégé: Dis Colon Rectum
Pays: United States
ID NLM: 0372764

Informations de publication

Date de publication:
11 Sep 2024
Historique:
medline: 12 9 2024
pubmed: 12 9 2024
entrez: 11 9 2024
Statut: aheadofprint

Résumé

Although loop ileostomy as a diverting stoma has been considered to affect renal dysfunction, few reports have compared loop colostomy with loop ileostomy regarding renal function. This is an important issue in the current setting of increased opportunities to perform surgery on patients with poor renal function. This study aims to reveal the effect of ileostomy on renal dysfunction compared to colostomy following sphincter-preserving rectal surgery. This study was a retrospective analysis. We compared preoperative and postoperative blood urea nitrogen, serum creatinine and estimated glomerular filtration rate values. The study was conducted at a single academic institution in Osaka, Japan. From October 2013 to November 2021, 135 consecutive patients underwent rectal surgery with diverting stoma are included. Differences in pre- and postoperative renal function values by stoma creation site in patients with preoperative chronic kidney disease. Risk factors for patients with newly kidney disease after stoma creation. In the preoperative chronic kidney disease (+) patients, the differences between the pre- and post-values in the blood urea nitrogen (p = 0.047) and the serum creatinine (P = 0.028) values were higher than in the preoperative chronic kidney disease (-) patients. In the preoperative chronic kidney disease (+) patients, ileostomy was significantly associated with an elevation of the serum creatinine value (p = 0.025) and a decrease in estimated glomerular filtration rate value (p = 0.041) from the pre-operative one compared with that of colostomy. In multivariate analysis, ileostomy (odds ratio; 7.443, p = 0.011) and hypertension (4.226, p = 0.008) were independent risk factors of newly kidney disease postoperatively. Limitations to our study includes its retrospective nature and bias due to the stoma site being determined by each surgeon. We should take care to choose diverting stoma especially in patients with a risk of kidney disfunction. See Video Abstract.

Sections du résumé

BACKGROUND BACKGROUND
Although loop ileostomy as a diverting stoma has been considered to affect renal dysfunction, few reports have compared loop colostomy with loop ileostomy regarding renal function. This is an important issue in the current setting of increased opportunities to perform surgery on patients with poor renal function.
OBJECTIVE OBJECTIVE
This study aims to reveal the effect of ileostomy on renal dysfunction compared to colostomy following sphincter-preserving rectal surgery.
DESIGN METHODS
This study was a retrospective analysis. We compared preoperative and postoperative blood urea nitrogen, serum creatinine and estimated glomerular filtration rate values.
SETTINGS METHODS
The study was conducted at a single academic institution in Osaka, Japan.
PATIENTS METHODS
From October 2013 to November 2021, 135 consecutive patients underwent rectal surgery with diverting stoma are included.
MAIN OUTCOME MEASURES METHODS
Differences in pre- and postoperative renal function values by stoma creation site in patients with preoperative chronic kidney disease. Risk factors for patients with newly kidney disease after stoma creation.
RESULTS RESULTS
In the preoperative chronic kidney disease (+) patients, the differences between the pre- and post-values in the blood urea nitrogen (p = 0.047) and the serum creatinine (P = 0.028) values were higher than in the preoperative chronic kidney disease (-) patients. In the preoperative chronic kidney disease (+) patients, ileostomy was significantly associated with an elevation of the serum creatinine value (p = 0.025) and a decrease in estimated glomerular filtration rate value (p = 0.041) from the pre-operative one compared with that of colostomy. In multivariate analysis, ileostomy (odds ratio; 7.443, p = 0.011) and hypertension (4.226, p = 0.008) were independent risk factors of newly kidney disease postoperatively.
LIMITATIONS CONCLUSIONS
Limitations to our study includes its retrospective nature and bias due to the stoma site being determined by each surgeon.
CONCLUSION CONCLUSIONS
We should take care to choose diverting stoma especially in patients with a risk of kidney disfunction. See Video Abstract.

Identifiants

DOI: 10.1097/DCR.0000000000003517 PMID: 39260442
pubmed: 39260442
doi: 10.1097/DCR.0000000000003517
pii: 00003453-990000000-00746
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © The ASCRS 2024.

Auteurs

Takuki Yagyu (T)

Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Hirakata, Japan.
Department of Surgery, Kansai Medical University Hospital, Hirakata, Japan.

Madoka Hamada (M)

Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Hirakata, Japan.

Masahiko Hatta (M)

Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Hirakata, Japan.
Department of Surgery, Kansai Medical University Hospital, Hirakata, Japan.

Toshinori Kobayashi (T)

Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Hirakata, Japan.
Department of Surgery, Kansai Medical University Hospital, Hirakata, Japan.

Yuki Matsumi (Y)

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Ryo Inada (R)

Department of Gastroenterological Surgery, Kochi Health Sciences Centre, Kochi, Japan.

Tomoko Matsumoto (T)

Department of Gastroenterological Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan.

Masaharu Oishi (M)

Oishi Clinic, Minoh, Japan.

Classifications MeSH