Prediction model and treatment of high‑output ileostomy in colorectal cancer surgery

Fujino,Shiki; Miyoshi,Norikatsu; Ohue,Masayuki; Takahashi,Yuske; Yasui,Masayoshi; Sugimura,Keijiro; Akita,Hirohumi; Takahashi,Hidenori; Kobayashi,Shogo; Yano,Masahiko; Sakon,Masato

doi:10.3892/mco.2017.1336

September-2017 Volume 7 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

September-2017 Volume 7 Issue 3

Full Size Image

Article

Prediction model and treatment of high‑output ileostomy in colorectal cancer surgery

Authors:
- Shiki Fujino
- Norikatsu Miyoshi
- Masayuki Ohue
- Yuske Takahashi
- Masayoshi Yasui
- Keijiro Sugimura
- Hirohumi Akita
- Hidenori Takahashi
- Shogo Kobayashi
- Masahiko Yano
- Masato Sakon
View Affiliations / Copyright

Affiliations: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565‑0871, Japan, Department of Surgery, Osaka International Cancer Institute, Osaka 541‑8567, Japan
Pages: 468-472
|
Published online on: July 19, 2017

https://doi.org/10.3892/mco.2017.1336
Expand metrics +

Abstract

The aim of the present study was to examine the risk factors of high‑output ileostomy (HOI), which is associated with electrolyte abnormalities and/or stoma complications, and to create a prediction model. The medical records of 68 patients who underwent colorectal cancer surgery with ileostomy between 2011 and 2016 were retrospectively investigated. All the patients underwent surgical resection for colorectal cancer at the Osaka Medical Center for Cancer and Cardiovascular Diseases (Osaka, Japan). A total of 7 patients with inadequate data on ileostomy output were excluded. Using a group of 50 patients who underwent surgery between 2011 and 2013, the risk of HOI was classified by a decision tree model using a partition platform. The HOI prediction model was validated in an additional group of 11 patients who underwent surgery between 2014 and 2016. Univariate analysis of clinical factors demonstrated that young age (P=0.003) and high white blood cell (WBC) count (P<0.001) after surgery were significantly correlated with HOI. Operative factors, such as surgical procedure, approach, operative time and blood loss, were not significantly correlated with HOI. Using these clinical factors, the risk of HOI was classified by statistical partition. In this model, three factors (gender, age and WBC on postoperative day 1) were generated for the prediction of HOI. The patients were classified into five groups, and HOI was observed in 0‑88% of patients in each group. The area under the curve (AUC) was 0.838. The model was validated by an external dataset in an independent patient group, for which the AUC was 0.792. In conclusion, HOI patients were classified and an HOI prediction model was developed that may help clinicians in postoperative care.

View Figures

View References

1	Glimelius B, Tiret E, Cervantes A and Arnold D: ESMO Guidelines Working Group: Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 24 Suppl 6:vi81–vi88. 2013. View Article : Google Scholar : PubMed/NCBI
2	Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, Hamaguchi T, Hyodo I, Igarashi M, Ishida H, et al: Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 20:207–239. 2015. View Article : Google Scholar : PubMed/NCBI
3	Matthiessen P, Hallböök O, Rutegård J, Simert G and Sjödahl R: Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: A randomized multicenter trial. Ann Surg. 246:207–214. 2007. View Article : Google Scholar : PubMed/NCBI
4	Veenhof AA, van der Peet DL, Meijerink WJ and Cuesta MA: Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: A randomized multicenter trial. Ann Surg. 247:718–720. 2008. View Article : Google Scholar : PubMed/NCBI
5	Katsuno H, Shiomi A, Ito M, Koide Y, Maeda K, Yatsuoka T, Hase K, Komori K, Minami K, Sakamoto K, et al: Comparison of symptomatic anastomotic leakage following laparoscopic and open low anterior resection for rectal cancer: A propensity score matching analysis of 1014 consecutive patients. Surg Endosc. 30:2848–2856. 2016. View Article : Google Scholar : PubMed/NCBI
6	Baker ML, Williams RN and Nightingale JM: Causes and management of a high-output stoma. Colorectal Dis. 13:191–197. 2011. View Article : Google Scholar : PubMed/NCBI
7	Villafranca JJ Arenas, López-Rodriguez C, Abilés J, Rivera R, Gándara Adán N and Navarro P Utrilla: Protocol for the detection and nutritional management of high-output stomas. Nutr J. 14:452015. View Article : Google Scholar : PubMed/NCBI
8	Rostami K and Al Dulaimi D: Elemental diets role in treatment of high ileostomy output and other gastrointestinal disorders. Gastroenterol Hepatol Bed Bench. 8:71–76. 2015.PubMed/NCBI
9	Newton CR: Effect of codeine phosphate, Lomotil, and Isogel on iileostomy function. Gut. 19:377–383. 1978. View Article : Google Scholar : PubMed/NCBI
10	King RF, Norton T and Hill GL: A double-blind crossover study of the effect of loperamide hydrochloride and codeine phosphate on ileostomy output. Aust N Z J Surg. 52:121–124. 1982. View Article : Google Scholar : PubMed/NCBI
11	Artinyan A, Nunoo-Mensah JW, Balasubramaniam S, Gauderman J, Essani R, Gonzalez-Ruiz C, Kaiser AM and Beart RW Jr: Prolonged postoperative ileus-definition, risk factors, and predictors after surgery. World J Surg. 32:1495–1500. 2008. View Article : Google Scholar : PubMed/NCBI
12	Gaertner WB, Madoff RD, Mellgren A, Kwaan MR and Melton GB: Postoperative diarrhea and high ostomy output impact postoperative outcomes after elective colon and rectal operations regardless of Clostridium difficile infection. Am J Surg. 210:759–765. 2015. View Article : Google Scholar : PubMed/NCBI
13	Greenberg DE, Jiang ZD, Steffen R, Verenker MP and DuPont HL: Markers of inflammation in bacterial diarrhea among travelers, with a focus on enteroaggregative Escherichia coli pathogenicity. J Infect Dis. 185:944–949. 2002. View Article : Google Scholar : PubMed/NCBI
14	Neurath MF: Cytokines in inflammatory bowel disease. Nat Rev Immunol. 14:329–342. 2014. View Article : Google Scholar : PubMed/NCBI
15	Arita M, Yoshida M, Hong S, Tjonahen E, Glickman JN, Petasis NA, Blumberg RS and Serhan CN: Resolvin E1, an endogenous lipid mediator derived from omega-3 eicosapentaenoic acid, protects against 2,4,6-trinitrobenzene sulfonic acid-induced colitis. Proc Natl Acad Sci USA. 102:7671–7676. 2005. View Article : Google Scholar : PubMed/NCBI
16	Konuma K, Itoh M, Suganami T, Kanai S, Nakagawa N, Sakai T, Kawano H, Hara M, Kojima S, Izumi Y and Ogawa Y: Eicosapentaenoic acid ameliorates non-alcoholic steatohepatitis in a novel mouse model using melanocortin 4 receptor-deficient mice. PLoS One. 10:e01215282015. View Article : Google Scholar : PubMed/NCBI
17	Read JA, Beale PJ, Volker DH, Smith N, Childs A and Clarke SJ: Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: A phase II trial. Support Care Cancer. 15:301–307. 2007. View Article : Google Scholar : PubMed/NCBI
18	Sánchez-Lara K, Turcott JG, Juárez-Hernández E, Nuñez-Valencia C, Villanueva G, Guevara P, De la Torre-Vallejo M, Mohar A and Arrieta O: Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer: Randomised trial. Clin Nutr. 33:1017–1023. 2014. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Prediction model and treatment of high‑output ileostomy in colorectal cancer surgery

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Related Articles