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Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure.
- Source :
-
Langenbeck's Archives of Surgery . Feb2019, Vol. 404 Issue 1, p39-43. 5p. - Publication Year :
- 2019
-
Abstract
- Purpose: The present study aimed to analyze the impact of perioperative fluid management on postoperative ileus (POI) after loop ileostomy closure.Methods: Consecutive loop ileostomy closures over a 6-year period (May 2011-May 2017) were included. Main outcomes were POI, defined as time to first stool beyond POD 3, and postoperative complications of any grade. Critical fluid management-related thresholds including postoperative weight gain were identified through receiver operator characteristics (ROC) analysis and tested in a multivariable analysis.Results: Of 238 included patients, 33 (14%) presented with POI; overall complications occurred in 91 patients (38%). 1.7 L IV fluids at postoperative day (POD) 0 was determined a critical threshold for POI (area under ROC curve (AUROC), 0.64), yielding a negative predictive value (NPV) of 93%. Further, a critical cutoff for a postoperative weight gain of 1.2 kg at POD 2 was identified (AUROC, 0.65; NPV, 95%). Multivariable analysis confirmed POD 0 fluids of > 1.7 L (OR, 4.7; 95% CI, 1.4-15.3; p = 0.01) and POD 2 weight gain of > 1.2 kg (OR, 3.1; 95% CI, 1-9.4; p = 0.046) as independent predictors for POI.Conclusions: Perioperative fluid administration of > 1.7 L and POD 2 weight gain of > 1.2 kg represent critical thresholds for POI after loop ileostomy closure. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14352443
- Volume :
- 404
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Langenbeck's Archives of Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 134941606
- Full Text :
- https://doi.org/10.1007/s00423-018-1744-4