A sustaining rod increases necrosis of loop ileostomies: a randomized controlled trial.

Zindel, Joel; Gygax, Chantal; Studer, Peter; Kauper, Melanie; Candinas, Daniel; Banz Wüthrich, Vanessa; Brügger, Lukas (2017). A sustaining rod increases necrosis of loop ileostomies: a randomized controlled trial. International journal of colorectal disease, 32(6), pp. 875-881. Springer 10.1007/s00384-017-2813-9

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PURPOSE Defunctioning loop ileostomies (LI) are commonly used in colorectal surgery to reduce the potentially detrimental consequences of anastomotic leakages. However, stoma-related morbidity is high with up to 75% of patients having local complications. The aim of this study was to investigate the effect of a sustaining rod on the local complication rate. METHODS In this prospective, multi-center, randomized controlled trial, subjects were allocated to either a rod or a rod-less protocol (NCT00959738). The primary outcome was local morbidity as measured by a stoma specific morbidity score (SSMS) during the first 3 months postoperatively. RESULTS Between August 2008 and July 2014, a total of 122 patients were enrolled in the study, of which 78 (63.8%) completed the study [44 (56.4%) rod, 34 (43.6%) rod-less]. There was no significant difference in the SSMS between the two groups. The incidence of necrosis or partial necrosis, however, was significantly increased in the rod group: 13 (29.5%) vs. 1 (2.9%) in the rod-less group (p < 0.01). The retraction rate did not differ significantly between the groups: two (4.5%) in the rod vs. five (14.7%) in the rod-less group (p = 0.13). High body mass index (BMI > 26) was associated with an odds ratio of 5 (p < 0.01) for severe stoma complications. CONCLUSIONS A rod-less technique for loop ileostomies reduces the risk of stomal necrosis, with a high BMI being an independent risk factor for stomal complications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy

UniBE Contributor:

Zindel, Joel; Gygax, Chantal; Studer, Peter; Candinas, Daniel; Banz Wüthrich, Vanessa and Brügger, Lukas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-1262

Publisher:

Springer

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

18 Jan 2018 09:54

Last Modified:

18 Jan 2018 09:54

Publisher DOI:

10.1007/s00384-017-2813-9

PubMed ID:

28417196

Uncontrolled Keywords:

Defunctioning stoma Local stomal complications Loop ileostomy Sustaining rod

BORIS DOI:

10.7892/boris.109036

URI:

https://boris.unibe.ch/id/eprint/109036

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