title: The influence of nutritional assessment on the outcome of ostomy takedown.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Surgery, Chonnam National University Hospital, Gwangju, Korea.
authors: Min Sang
authors: MS
authors: Kim
authors: Ho Kun
authors: HK
authors: Kim
authors: Dong Yi
authors: DY
authors: Kim
authors: Jae Kyun
authors: JK
authors: Ju