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Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period Cover

Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period

Open Access
|Sep 2019

Figures & Tables

Complications according to Clavien-Dindo

Clavien- Dindon (%)
0164 (75.2)
120 (9.2)
218 (8.3)
3b9 (4.1)
4a3 (1.4)
54 (1.8)

Type of stoma and closure technique

Anterior Wall SuturesResection With AnastomosisTogether
Ileostomy7 (7%)95 (93%)102
Colostomy69 (59%)47 (41%)116
Together76 (35%)142 (65%)218

Clinical characteristics

N = 218
Age64.6 years (26 – 90)
Sex
Male136 (62%)
Female82 (38%)
ASA score
160 (27%)
2102 (47%)
326 (12%)
41 (0.5%)
Time to closure248 days (30 – 911)

The effect of different variables on complication rate

Type of closureAWSRWAp
All complications16 (7.3%)38 (17.4%)> 0.05
Severe complications5 (2.2%)11 (5%)> 0.05
Age< 65 years> 65 yearsp
All complications23 (10.5%)31 (14.2%)> 0.05
Severe complications4 (1.8%)12 (5.5%)> 0.05
ASA statusASA 1 & 2ASA 3 & 4p
All complications38 (17.4%)6 (3%)> 0.05
Severe complications13 (6%)3 (1.3%)> 0.05
Type of stomaIleostomyColostomyp
All complications27 (12.4%)27 (12.4%)> 0.05
Severe complications9 (4.1%)7 (3.2%)> 0.05
Time to closure<240 days>240 daysp
All complications14 (6.4%)40 (18%)= 0.044
Severe complications4 (1.8%)12 (5.5%)> 0.05

Clavien-Dindo classification

GradeExplanation
Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic
1and radiological interventions. Acceptable therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics and
electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside.
2Requiring pharmacological treatment with drugs other than such allowed for grade I complications. Blood transfusions, antibiotics and total parenteral nutrition are also included.
3Requiring surgical, endoscopic or radiological intervention.
aIntervention under regional/local anesthesia.
bIntervention under general anesthesia.
4Life-threatening complication requiring intensive care/intensive care unit management.
aSingle organ dysfunction.
bMulti-organ dysfunction.
5Patient demise.
DOI: https://doi.org/10.2478/raon-2019-0037 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 331 - 336
Submitted on: Mar 21, 2019
|
Accepted on: Jul 15, 2019
|
Published on: Sep 24, 2019
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2019 Bojan Krebs, Arpad Ivanecz, Stojan Potrc, Matjaz Horvat, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.