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Interventions to reduce dehydration related to defunctioning loop ileostomy after low anterior resection in rectal cancer: a prospective cohort study.
- Source :
- ANZ Journal of Surgery; Sep2020, Vol. 90 Issue 9, p1627-1631, 5p
- Publication Year :
- 2020
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14451433
- Volume :
- 90
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- ANZ Journal of Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 145731894
- Full Text :
- https://doi.org/10.1111/ans.16258