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Chirurgia 2022 June;35(3):155-60

DOI: 10.23736/S0394-9508.21.05325-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Impact of defunctioning loop ileostomy on renal function and hydroelectrolyte balance in rectal cancer patients

María Jesús SEGURA GIMÉNEZ 1 , Rodolfo RODRÍGUEZ CARRILLO 1, María del Carmen AZORÍN SAMPER 1, Marina ALARCÓN IRANZO 1, María Dolores RUIZ CARMONA 1, Roberto LOZOYA TRUJILLO 1, Amparo SOLANA BUENO 1, Rafael ALÓS COMPANY 2

1 Department of General and Digestive Surgery, Sagunto Hospital, Sagunto, Spain; 2 Department of General and Digestive Surgery, La Fe Hospital, Valencia, Spain



BACKGROUND: Performing a protective ileostomy to protect a low colorectal anastomosis is a surgical procedure that is not without complications. Our objective is to determine the impact of the creation of a protective ileostomy on renal function and hydroelectrolyte balance.
METHODS: Retrospective study of patients who have undergone surgery for rectal cancer divided into a group with protective ileostomy and a control group. Changes in renal function and electrolytes were evaluated by reviewing the analyses performed in the follow-up (preoperative and 2-3 months after surgery). In ileostomy carriers, changes before and after closure have also been reviewed.
RESULTS: Seventy-six patients were evaluated (43 with ileostomy and 33 without ileostomy). In the ileostomy group, there was a significant increase in creatinine levels (0.88 [±0.22] to 1.01 [±0.38], P=0.007) and a significant decrease in glomerular filtrate (84.41 [±17.00] to 77.43 [±22.58], P=0.002). In these patients, sodium levels decreased significantly (142.07 [±2.99] to 139.95 [±4.15], P=0.004). In the control group, only a significant decrease in potassium levels was observed. After the closure of the ileostomy, a significant decrease in creatinine and a significant increase in glomerular filtrate were observed.
CONCLUSIONS: The performance of a protective ileostomy after an anterior rectum resection is associated with a worsening of renal function and a decrease in sodium levels after surgery. A significant improvement of these parameters was observed after closure surgery.


KEY WORDS: Ileostomy; Delayed graft function; Disease; Rectal neoplasms

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