title: [Complications associated with closure of defunctioning loop ileostomy in low anterior resection of rectal cancer].
abstract: OBJECTIVE
  To analyze the complications of ileostomy closure and related risk factors.
  
  
  METHODS
  Patients undergoing ileostomy closure in the Department of Colorectal Surgery, Peking University Cancer Hospital from September 2006 to March 2013 were included in this study. Clinical features of these patients were reviewed, the complications rate was calculated, and univariate and multivariate analyses with regard to the risk factors of surgical site infection(SSI) were also conducted.
  
  
  RESULTS
  A total of 245 consecutive patients were enrolled in the study. Thirty-nine complications were observed in thirty-three patients, the overall complication rate was 13.5%. Complication after primary closure of defunctioning ileostomy included surgical site infection (n=21, 8.6%), ileus (n=8, 3.3%), preoperatively undiagnosed anastomotic leakage or rectovaginal fistula (n=5, 2.0%), pulmonary infection (n=2, 0.8%), and anal sphincter dysfunction (n=2, 0.8%). No patient died in the perioperative period, and 5 patients (2.0%) underwent reoperation for ileus (n=3), anastomotic leakage (n=1) and rectovaginal fistula (n=1). Multivariate analysis showed that postoperative complications [OR=10.576, 95%CI:2.898-38.597, P=0.000] and total operation time>90 min[OR=4.862, 95% CI:1.758-13.451, P=0.002] were independent risk factors of SSI, and the presence of subcutaneous vacuum drainage [OR=0.063, 95%CI:0.007-0.540, P=0.012] was protective factor of SSI.
  
  
  CONCLUSIONS
  Surgical site infection is the most common complication after primary closure of defunctioning ileostomy. Subcutaneous vacuum drainage is effective for reducing SSI in patients undergoing primary closure of ileostomy, and it is especially recommended for patients with operation time>90 min.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Colorectal Surgery, Peking University Cancer Hospital and Institute, Beijing Cancer Hospital, Beijing 100142, China. zlgujin@126.com.
authors.forename: Hongda
authors.initials: H
authors.lastname: Pan
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Yifan
authors.initials: Y
authors.lastname: Peng
authors.forename: Jin
authors.initials: J
authors.lastname: Gu
mesh_terms: D001003:Anal Canal; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak; D005260:Female; D006801:Humans; D007081:Ileostomy; D015999:Multivariate Analysis; D061646:Operative Time; D011183:Postoperative Complications; D012004:Rectal Neoplasms; D012006:Rectovaginal Fistula; D012086:Reoperation; D012307:Risk Factors