Preoperative Hemoglobin Level as Predictor of the Development of High-output Stoma in Rectal Cancer Surgery

Tetsuro Kawazoe; Kippei Ohgaki; Yoshihiko Fujinaka; Huanlin Wang; Kazutoyo Morita; Ryota Nakanishi; Yoichi Ikeda

doi:10.21873/cdp.10270

Preoperative Hemoglobin Level as Predictor of the Development of High-output Stoma in Rectal Cancer Surgery

Cancer Diagn Progn. 2023 Nov 3;3(6):667-672. doi: 10.21873/cdp.10270. eCollection 2023 Nov-Dec.

Authors

Tetsuro Kawazoe^{1

2}, Kippei Ohgaki¹, Yoshihiko Fujinaka¹, Huanlin Wang¹, Kazutoyo Morita¹, Ryota Nakanishi², Yoichi Ikeda¹

Affiliations

¹ Department of Gastrointestinal Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
² Department of Surgery and Science, Kyushu University, Fukuoka, Japan.

Abstract

Background/aim: High-output stomas (HOSs) are a complication that can cause dehydration or renal dysfunction and affect the quality of life of patients, causing water, sodium, and magnesium depletion with malnutrition. Preoperative factors that are useful for predicting HOS are not well defined.

Patients and methods: A total of nine patients developed HOS among 31 patients who underwent rectal cancer surgery with ileostomies during 2014-2021. Clinicopathological and surgical parameters were also analyzed. HOS was defined as maximum output of ≥2,000 ml/day.

Results: The clinicopathological features did not differ between the HOS and non-HOS groups. Lower Hemoglobin (Hb) levels (<12 mg/dl) and longer operation times (≥300 min) were shown to be risk factors in the development of HOS.

Conclusion: Low Hb levels on preoperative blood tests were predictors of HOS development in patients who underwent rectal cancer surgery and ileostomies simultaneously in our data set. Further studies are required to improve the robustness of these findings.

Keywords: Rectal cancer; diverting ileostomy; high-output stoma.