Evidence map›Paper›PMID 33437402›Full record

ArticleWorld journal of gastrointestinal surgery2020

Risk factors for postoperative stoma outlet obstruction in ulcerative colitis.

Tomoaki Kitahara, Yu Sato, Takashi Oshiro, Rie Matsunaga, Makoto Nagashima, Shinichi Okazumi

Abstract read
In one paragraph

Article in World journal of gastrointestinal surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Tomoaki KitaharaDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan.
Yu SatoDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan. yu.sato@med.toho-u.ac.jp.
Takashi OshiroDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan.
Rie MatsunagaDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan.
Makoto NagashimaDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan.
Shinichi OkazumiDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Chiba, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent medical treatments can achieve remission of ulcerative colitis (UC). Surgery is required when potent drug treatment is ineffective or when colon cancer or high-grade dysplasia develops. The standard procedure is restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis, commonly performed as two- or three-stage RPC with diverting ileostomy. Postoperative stoma outlet obstruction (SOO) is frequent, but the causes are not well known.

aimTo identify the risk factors for SOO after stoma surgery in patients with UC.

methodsWe retrospectively reviewed the files of 148 consecutive UC patients who underwent surgery with stoma construction. SOO was defined as small bowel obstruction symptoms and intestinal dilatation just below the penetrating part of the stoma on computed tomography. Patients were divided into two groups: Those who developed SOO within 30 d after surgery and those who did not. Patient characteristics, intraoperative parameters, the stoma site, and rectus abdominis muscle thickness were collected. Moreover, we identified the patients who repeatedly developed SOO. Univariate and multivariate analyses were performed to identify risk factors for SOO and recurring SOO.

resultsEighty-nine patients who underwent two-stage RPC were included between January 2008 and March 2020. Postoperatively, SOO occurred in 25 (16.9%) patients after a median time of 9 d (range 2-26). Compared to patients without SOO, patients with SOO had a significantly higher rate of malignant tumors or dysplasia (36.0%

conclusionIn this study, high maximum stoma drainage volume and loop ileostomy are independent risk factors for SOO. Additionally, among patients with a thick rectus abdominis muscle, the risk of SOO recurrence is high.

Indexed as

Ileal pouch anal anastomosisIleostomyLoop ileostomyProctocolectomy and restorativeSurgical stomasTotal proctocolectomyUlcerative colitis

Identifiers

PMID33437402
PMCPMC7769745

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.