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  3. Stoma reversal after surgery for complicated acute diverticulitis: A multicentre retrospective study

Stoma reversal after surgery for complicated acute diverticulitis: A multicentre retrospective study

Fecha de publicación:

Autores de IIS La Fe

  • Ricardo Lucas Garcia-Mayor Fernandez

    Autor

  • Eduardo García-Granero Ximénez

    Autor

Participantes ajenos a IIS La Fe

  • Roig, JV
  • Salvador, A
  • Espinosa, J
  • Rosello, V
  • Hernandis, J
  • Ruiz-Carmona, MD
  • Uribe, N
  • Garcia-Calvo, R
  • Bernal, JC
  • Garcia-Armengol, J
  • Soc Valenciana Cirugia

Grupos

Abstract

Introduction: The aim was to analyse the stoma reversal rate after surgery for complicated acute diverticulitis (CAD), and more specifically the end-stoma-reversal, as well as the delay, feasibility, complications and risk factors for stoma maintenance. Methods: A multicentre retrospective study of patients who had undergone urgent surgery for CAD with stoma formation in ten hospitals during a period of 6 years. The frequency of reversal over time and the factors affecting the decision for reversal were analysed. Results: Out of 385 patients operated for CAD, 312 underwent stoma creation: 292 end colostomies and 20 diverting stomas. During follow-up, stoma reversal surgery was performed in 161 patients (51.6%) after a median of 9 months. The main causes for not performing stoma reversal were comorbidities and the death of the patient. Advanced age was an adverse factor in the multivariate analysis, and the actuarial rate of reversal was higher in men and in patients with no previous Hartmann's operation. Stoma reversal surgery was completed in all but one patient, and a loop ileostomy was associated in four. Morbidity and mortality rates were 35.7% and 1.9%, respectively. A total of 8.4% of patients underwent re-operation, and 6% experienced an anastomotic leak. Twelve patients remained with a stoma after the attempted reconstruction surgery. Conclusions: Surgery for CAD is frequently associated with an end stoma, which will ultimately not be reversed in almost 50% of patients. Moreover, reversal surgery is frequently delayed and is associated with significant morbidity and mortality. (C) 2018 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0009-739X, 1578-147X

CIRUGIA ESPANOLA  ELSEVIER ESPANA SLU

Tipo:
Article
Páginas:
283-291
PubMed:
29530275
Factor de Impacto:
0,189 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 4

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Keywords

  • Acute diverticulitis; Stoma reversal; Hartmann's reversal; Hartmann's operation; Postoperative complications

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