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The Influence of Nutritional Assessment on the Outcome of Ostomy Takedown

대한대장항문학회지 2012년 28권 3호 p.145 ~ 151
 ( Kim Min-Sang ) - Chonnam National University Hospital Department of Surgery

 ( Kim Ho-Kun ) - Chonnam National University Hospital Department of Surgery
김동의 ( Kim Dong-Yi ) - Chonnam National University Hospital Department of Surgery
 ( Ju Jae-Kyun ) - Chonnam National University Hospital Department of Surgery

Abstract


Purpose: Ostomy takedown is often considered a simple procedure without intention; however, it is associated with significant morbidity. This study is designed to evaluate factors predicting postoperative complications in the ostomy takedown in view of metabolism and nutrition.

Methods: A retrospective, institutional review-board-approved study was performed to identify all patients undergoing takedown of an ostomy from 2004 to 2010.

Results: Of all patients (150), 48 patients (32%; male, 31; female, 17) had complications. Takedown of an end-type ostomy showed a high complication rate; complications occurred in 55.9% of end-type ostomies and 15.7% of loop ostomies (P < 0.001). Severe adhesion was also related to a high rate of overall complication (41.3%) (P = 0.024). In preoperative work-up, ostomy type was not significantly associated with malnutrition status. However, postoperatively severe malnutrition level (albumin <2.8 mg/dL) was statistically significant in increasing the risk of complications (72.7%, P = 0.015). In particular, a significant postoperative decrease in albumin (>1.3 mg/dL) was associated with postoperative complications, particularly surgical site infection (SSI). Marked weight loss such as body mass index downgrading may be associated with the development of complications.

Conclusion: A temporary ostomy may not essentially result in severe malnutrition. However, a postoperative significant decrease in the albumin concentration is an independent risk factor for the development of SSI and complications.

키워드

Ostomy takedown; Malnutrition; Albumins; Surgical site infection; Complication
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