No survival advantage exists for patients undergoing loop ileostomy for clostridium difficile colitis

Bradley R. Hall, Jennifer A. Leinicke, Priscila R. Armijo, Lynette M. Smith, Sean J. Langenfeld, Dmitry Oleynikov

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: We aim to compare outcomes between loop ileostomy (LI) and total abdominal colectomy (TAC) for clostridium difficile infection (CDI) and hypothesize that LI is associated with fewer complications. Methods: The 2011–2016 ACS-NSQIP database was queried for patients undergoing LI or TAC for CDI. Patients with high outlying age, LOS, and operative time were excluded. Statistics were performed using IBM-SPSS and NCSS PASS-11. Results: Of 457 patients identified, 47 underwent LI. Predicted morbidity was higher in the TAC cohort (62% vs. 37%, p < 0.001). Patients in the LI cohort experienced fewer complications (72% vs. 87%, p = 0.021); however, mortality did not differ between LI (36%) and TAC (31%). Blood transfusions were more than twice as frequent in the TAC cohort (54% vs. 19%, p < 0.001). Four patients in the LI cohort required reoperation; however, none required colectomy. Conclusions: No mortality difference was observed between LI and TAC. Prospective studies are required to determine the utility of LI. An analysis of the ACS-NSQIP database was performed and demonstrates that no survival benefit exists for patients who undergo loop ileostomy for C difficile infection compared to those who undergo total colectomy; however, patients who undergo loop ileostomy are likely to retain their colon with low risk of requiring subsequent colectomy.

Original languageEnglish (US)
Pages (from-to)34-39
Number of pages6
JournalAmerican journal of surgery
Volume217
Issue number1
DOIs
StatePublished - Jan 2019

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Keywords

  • Clostridium difficile infection
  • Colectomy
  • Colon
  • Loop ileostomy
  • Mortality

ASJC Scopus subject areas

  • Surgery

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