Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure.

Details

Serval ID
serval:BIB_2A883BC71CAB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure.
Journal
Langenbeck's archives of surgery
Author(s)
Grass F., Pache B., Butti F., Solà J., Hahnloser D., Demartines N., Hübner M.
ISSN
1435-2451 (Electronic)
ISSN-L
1435-2443
Publication state
Published
Issued date
02/2019
Peer-reviewed
Oui
Volume
404
Number
1
Pages
39-43
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The present study aimed to analyze the impact of perioperative fluid management on postoperative ileus (POI) after loop ileostomy closure.
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.
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.
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.
Keywords
Adult, Aged, Cohort Studies, Female, Fluid Therapy, Humans, Ileostomy/adverse effects, Ileus/etiology, Ileus/prevention & control, Intraoperative Care, Length of Stay, Male, Middle Aged, Postoperative Complications/etiology, Postoperative Complications/prevention & control, ROC Curve, Rectal Diseases/surgery, Weight Gain, Complications, Fluid management, Loop ileostomy, Postoperative ileus, Weight gain
Pubmed
Web of science
Create date
04/02/2019 11:20
Last modification date
20/08/2019 13:10
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