title: The influence of specific technical maneuvers utilized in the creation of diverting loop-ileostomies on stoma-related morbidity.
abstract: OBJECTIVE
  The association between technical maneuvers in fashioning a diverting loop-ileostomy and stoma-related complications remains unclear. Thus, this study aimed to evaluate their relevance to stoma-related morbidity.
  
  
  METHODS
  This retrospective multicenter study was designed to collect data from 37 institutions. We evaluated the perioperative outcomes of consecutive patients who underwent surgery to create a diverting loop-ileostomy in 2013.
  
  
  RESULTS
  A total of 4137 patients with colorectal disease underwent colorectomy, 279 of whom received an ileostomy. The results of these 279 patients were analyzed. The most common complications were parastomal dermatitis (n = 132) followed by ileus (n = 36), mucocutaneous separation (n = 24), parastomal hernia (n = 16), stoma retraction (n = 15), and stoma prolapse (n = 9). The technical maneuvers used in the creation of ileostomies were heterogeneous and some had a great deal of relevance to the complications. A long distance from the ileocecal valve to the ileostomy was associated with a low risk of stoma retraction and a high risk of ileus. Additionally, the height of the distal limb of the ileostomy significantly affected the incidence of parastomal dermatitis and mucocutaneous separation.
  
  
  CONCLUSIONS
  Specific technical maneuvers that are utilized in the creation of diverting loop-ileostomies had a significant influence on the incidence of stoma-related morbidities. Our findings emphasize the possibility of minimizing stoma-related complications with appropriate surgical techniques.
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyo
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan. itakemasa@sapmed.ac.jp.|Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S-1, W-17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan. itakemasa@sapmed.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.affiliation: National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Sakai City Hospital, Sakai, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Tujie
authors.affiliation: Osaka Rosai Hospital, Sakai, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.affiliation: Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.affiliation: Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D003872:Dermatitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006547:Hernia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D045823:Ileus / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D009017:Morbidity; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011391:Prolapse; D012189:Retrospective Studies; D054047:Surgical Stomas / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Complications; Diverting loop-ileostomy; Technical maneuvers