Background: Defunctioning loop ileostomy (DLI) in low anterior resection (LAR) in rectal cancer patients reduces the morbidity of anastomotic leakages. In our previous study, 30% of patients developed dehydration due to DLI, mostly during the first 6 weeks. This interventional study aimed to reduce these figures by establishing a surveillance programme.

Methods: An interventional study of rectal cancer patients undergoing LAR and DLI between 2013 and 2015 was carried out. A historical study group was used as control. Stoma care nurses educated the intervention group about high-output stoma. Blood tests, including creatinine and electrolytes, were taken every second week until 8 weeks post-operatively and an additional control in case of subjective high-output stoma.

Results: Eighty-seven patients underwent LAR and DLI during the study period. Twenty-one (24%) developed dehydration episodes, and nine (43%) of them required readmission. There was no difference compared to the control group, where 29% developed dehydration, and about half (52%) needed readmission (P = 0.62 and P = 0.57, respectively). However, when explicitly examining patients demonstrating symptomatic dehydration, there was a significant difference, that is 10 (11%) versus 27 (29%) (P < 0.005). Overall, the dehydrated group was older and more likely to take diuretics compared to the non-dehydrated group.

Conclusion: Our results indicate that reducing dehydration episodes and readmission after DLI is a challenging process. The proposed surveillance was only effective in preventing symptomatic dehydration. Subjects taking diuretics and the elderly are at risk of dehydration and should be followed cautiously.

Download full-text PDF

Source
http://dx.doi.org/10.1111/ans.16258DOI Listing

Publication Analysis

Top Keywords

rectal cancer
12
developed dehydration
12
defunctioning loop
8
loop ileostomy
8
low anterior
8
anterior resection
8
cancer patients
8
interventional study
8
lar dli
8
study
6

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!