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Risk of Outlet Obstruction Associated With Defunctioning Loop Ileostomy in Rectal Cancer Surgery

Hiroya Enomoto¹, Katsuhito Suwa¹, Nana Takeuchi¹

¹Department of Surgery, The Jikei University Daisan Hospital, Komae, Japan.

Cancer Diagnosis & Prognosis

|April 11, 2022

Abstract

Background:

The outlet obstruction (OO) rate is 5.4-18.4% after defunctioning ileostomy (DI) following rectal cancer resection to reduce the incidence and severity of anastomotic leakage; OO affects a patient's quality of life and prolongs hospitalization.

Patients And Methods:

A retrospective analysis was performed of patients who underwent anterior rectal resection and DI for rectal cancer.

Results:

Among 100 patients undergoing anterior rectal resection with DI for rectal cancer, 28 (28%) developed OO. Anastomotic leakage and a rectus abdominis muscle thickness ≥10 mm on preoperative computed tomography were significantly associated with the risk of OO in univariate analysis. Multivariate analysis also demonstrated that anastomotic leakage (odds ratio=4.320, 95% confidence interval=1.280-14.60, p=0.019) and rectus abdominis muscle thickness ≥10 mm (odds ratio=3.710, 95% confidence intervaI=1.280-10.70, p=0.016) were significantly risk factors for OO.

Conclusion:

When OO is observed, an anastomotic leakage should be suspected, especially if there is a high rectus abdominis muscle thickness.

Keywords:

Outlet obstruction defunctioning ileostomy loop ileostomy rectal cancer

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