Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Surgery

Supervisor

Christopher Vinden

2nd Supervisor

Michael Ott

Joint Supervisor

3rd Supervisor

Kelly Vogt

Co-Supervisor

Abstract

There is evidence that defunctioning loop ileostomies (DLIs) are associated with decreased risk of clinically significant anastomotic leaks, but at what cost? This population-based retrospective cohort study used administrative data to investigate differences in outcomes between patients undergoing low anterior resection with and without DLIs. We included all adult patients undergoing low anterior resection from 2002 to 2014 and identified outcomes within 30-days to 2-year of the index surgery. Outcomes included hospital readmission, reoperation, major complications, mortality, bleeding, and ileostomy reversal. DLIs were associated with significantly worse outcomes after low anterior resection, including increased risk of major complication, acute kidney injury, readmission, ventral hernia, bowel obstruction. There is certainly a role for DLIs to decrease risk of significant anastomotic leak requiring intervention and/or operation; however, DLIs are not benign entities. Based on the results of this study, it can be argued that selective utilization of DLIs should be recommended and further research into risk stratification and identification of patients who would benefit the most from DLIs are warranted.

Available for download on Wednesday, July 01, 2020

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