Estudio del tratamiento quirúrgico mediante cierre precoz de ileostomia en cáncer de recto: impacto en la calidad de vida, descenso de morbimortalidad y gasto sanitario

  1. Gallart Aragón, Tania 1
  2. Fernández Lao, Carolina 1
  3. Garde Lecumberri, Carlos 1
  4. Mirón Pozo, Benito 1
  5. Pérez Benítez, Francisco 1
  6. Jiménez Ríos, José Antonio 1
  1. 1 Universidad de Granada
    info

    Universidad de Granada

    Granada, España

    ROR https://ror.org/04njjy449

Journal:
Actualidad médica

ISSN: 0365-7965

Year of publication: 2016

Tome: 101

Issue: 797

Pages: 30-32

Type: Article

DOI: 10.15568/AM.2016.797.OR05 DIALNET GOOGLE SCHOLAR lock_openDIGIBUG editor

More publications in: Actualidad médica

Sustainable development goals

Abstract

Introduction: Patients undergoing rectal surgery with low anastomosis and carrying ileostomy protection, can see extended the interval between placing the stoma and the reconstructive surgery, sometimes during months, while the adjuvant treatment is being developed. The aim of this study was to assess the impact on the Quality of Life, changes in morbidity and mortality and health costs before the closure of the ileostomy prior to the adjuvant treatment. Material and methods: Retrospective study. 55 patients underwent closure of the ileostomy between January 2012 and December 2013 were studied. The sample consisted on 41 (74.54%) men and 14 (25.45%) women. In 27 Patients the closure of the ileostomy was performed in 1 year from its creation and in 28 patients was closed in one month. Morbidity and mortality, medical cost and Quality of Life were analyzed. Results: The average age was 63.83 years. Patients with early closure of ileostomy had a mean hospital stay lower, 11.87 days compared to patients with annual closure, 14.96 days, and so descending health costs. 18, 33% of patients with early closure of ileostomy presented postoperative ileus against the 65.3% of late closure. Quality of Life in Patients with early closure has been assessed 61, 2% compared to 33.44% in patients with late closure. Conclusions: Performing protection ileostomy in low rectal anastomosis has proven to be a preventive effective measure in reducing morbidity and mortality dehiscence. Early closure of the ileostomy reduces postoperative ileus, the average of hospital stay, and improves quality of life and health costs.

Bibliographic References

  • Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E. Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy. Br J Surg 2008;95(6):693-8
  • Carlsen E, Bergan AB. Loop ileostomy: technical aspects and complications. Eur J Surg 1999;165(2):140-3
  • Chude GG, Ravate NV, Patris V, Koshariva M, Jagad R, Kawamoto J, et al. Defunctioning loop ileostomy with low anterior resection for distal rectal cancer: Should we make an ileostomy as a routine procedure. A prospective randomized study. Hepatogastroenterology. 2008;55:1562-7.
  • Courtier R, Parés D, Silva CA, Gil MJ, Pascual M, Alonso S, et al. Clinical results of loop ileostomy closures in rectal cancer surgical patients. Effect of chemotherapy in the waiting period. Cir Esp 2010; 88(5):308-13.
  • Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg 1995;82:216-22.
  • Furlani R, Ceolim MF. Living with a permanent intestinal stoma: changes told by stoma patient. Rev Bras Enferm 2002; 55: 586-91.
  • Gastinger I, Marusch F, Steinert R, Wolff S, Koeckerling F, Lippert H; Working Group ‘Colon/Rectum Carcinoma’. Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg 2005;92(9):1137-42
  • Menegaux F, Jordi-Galais P, Turrin N, Chigot JP. Closure of small bowel stomas on postoperative day 10. Eur J Surg 2002;168(12):713-59. Perez RO, Habr-Gama A, Seid VE, Proscurshim I, Sousa AH Jr, Kiss DR, et al. Loop ileostomy morbidity: timing of closure matters. Dis Colon Rectum 2006;49(10):1539-45. 1
  • Peeters KC, Tollenaar RA, Marijnen CA, Klein Kranenbarg E, Steup WH, Wiggers T, et al. Dutch Colorectal Cancer Group. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg 2005;92(2):211-6
  • Perez RO, Habr-Gama A, Seid VE, Proscurshim T, Sousa AH, Kiss DR, et al. Loop ileostomy morbidity: Timing of closure matters. Dis Colon Rectum. 2006;49:1539-45.
  • Rondelli F, Reboldi P, Rulli A, Barberini F, Guerrisi A, Izzo L, et al. Loop ileostomy for fecal diversion after colorectal or coloanal anastomosis: a meta-analysis. Int J Colorrectal Dis. 2009;24:479-88.
  • Ruiz MD, Durán MC, Rivera S y cols. Calidad de vida y necesidades de personas ostomizadas y sus cuidadores. Rev ROL Enf 2003; 26: 309-14.
  • Shabbir J, Britton DC. Stoma complications: A literature overview. Colorectal Dis. 2010;12:958-64.
  • Smedh K, Olsson L, Johansson H, Aberg C, Andersson M. Reduction of postoperative morbidity and mortality in patients with rectal cancer following the introduction of a colorectal unit. Br J Surg 2001; 88(2):273-7.
  • Tang CL, Seow-Choen F, Fook-Chong S, Eu KW. Bioresorbable adhesion barrier facilates early closure of the defunctioning ileostomy after rectal excision: A prospective, randomized trial. Dis Colon Rectum. 2003;46:1200-7.
  • Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D. Morbidity of temporary loop ileostomy in patients with colorectal cancer. Dis Colon Rectum 2006;49(7):1011-7
  • Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D. Morbidity of temporary loop ileostomy in patients with colorectal cancer. Dis Colon Rectum. 2006;49:1011-7.
  • Turnbull GB, Colwell J, Erwin-Toth P. Quality of life : pre, post and beyond ostomy surgery. Clinician strategies for helping people with a stoma lead helthy productive lives. Ostomy Wound Management 2004; 50: 2-12.
  • Wijesuriya SR, Hewavisenthi J, Deen KI. Patiens with rectal cancer having neoadyuvant chemoradiation do not have increased complications of ileostomy closure. Ceylon Med. 2010;55:115-7.
  • Wong KS, Remzi FH, Gorgun E, Arrigain S, Church JM, Preen M, et al. Loop ileostomy closure after restorative proctocolectomy: outcome in 1,504 patients. Dis Colon Rectum 2005;48(2):243-50.
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