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KMID : 0371420211010020111
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Annals of Surgical Treatment and Research
2021 Volume.101 No. 2 p.111 ~ p.119
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Diverting ileostomy itself may not increase the rate of postoperative readmission related to dehydration after low anterior resection
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Park Sung-Sil
Kim Min-Jung
Lee Dong-Eun
Park Sung-Chan
Han Kyung-Su
Hong Chang-Won
Sohn Dae-Kyung
Chang Hee-Jin
Oh Jae-Hwan
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Abstract
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Purpose: This study was performed to evaluate the risk of readmission in the first year after low anterior resection (LAR) for patients with rectal cancer and to identify the contributing factors for readmission related to dehydration specifically.
Methods: This was a retrospective analysis of 570 patients who underwent LAR for rectal cancer at National Cancer Center, Republic of Korea. A diverting loop ileostomy was performed in 357 (62.6%) of these patients. Readmission was defined as an unplanned visit to the emergency room or admission to the ward. The reasons for readmission were reviewed and compared between the ileostomy (n = 357) and no-ileostomy (n = 213) groups. The risk factors for readmission and readmission due to dehydration were analyzed using multivariable logistic and Cox proportional hazard model.
Results: Dehydration was the most common cause of readmission in both groups (ileostomy group, 6.7%, and no-ileostomy group, 4.7%, P = 0.323). On multivariable analysis, risk factors for readmission were an estimated intraoperative blood loss of ≥400 mL (odds ratio [OR], 1.757; 95% confidence interval [CI], 1.058?2.918; P = 0.029), and postoperative chemotherapy (OR, 2.914; 95% CI, 1.824?4.653; P < 0.001). On multivariable analysis, postoperative chemotherapy, and not a diverting loop ileostomy, was an independent risk factor for dehydration-related readmission (OR, 5.102; 95% CI, 1.772?14.688; P = 0.003).
Conclusion: The most common cause of readmission after LAR for rectal cancer was dehydration, as reported previously. Postoperative chemotherapy, not the creation of a diverting ileostomy, was identified as the risk factor associated with readmission related to dehydration.
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KEYWORD
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Dehydration, Drug therapy, Ileostomy, Patient readmission
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