Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy. A systematic review and meta‐analysis
Aim This systematic review aims to assess dehydration prevalence and dehydration‐related morbidity from diverting ileostomy compared to resections without ileostomy formation in adults undergoing colorectal resection for cancer. Method MEDLINE, Embase, CENTRAL and ClinicalTrials.gov were searched fo...
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Published in | Colorectal disease Vol. 23; no. 7; pp. 1721 - 1732 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
Wiley Subscription Services, Inc
01.07.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Aim
This systematic review aims to assess dehydration prevalence and dehydration‐related morbidity from diverting ileostomy compared to resections without ileostomy formation in adults undergoing colorectal resection for cancer.
Method
MEDLINE, Embase, CENTRAL and ClinicalTrials.gov were searched for studies of any design that reported dehydration, renal function and dehydration‐related morbidity in adult colorectal cancer patients with diverting ileostomy (last search 12 August 2020). Bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the Risk of Bias in Non‐randomized Studies of Interventions tool.
Results
Of 1927 screened papers, 22 studies were included (21 cohort studies and one randomized trial) with a total of 19 485 patients (12 209 with ileostomy). The prevalence of dehydration was 9.00% (95% CI 5.31–13.45, P < 0.001). The relative risk of dehydration following diverting ileostomy was 3.37 (95% CI 2.30–4.95, P < 0.001). Three studies assessing long‐term trends in renal function demonstrated progressive renal impairment persisting beyond the initial insult. Consequences identified included unplanned readmission, delay or non‐commencement of adjuvant chemotherapy, and development of chronic kidney disease.
Discussion
Significant dehydration is common following diverting ileostomy; it is linked to acute kidney injury and has a long‐term impact on renal function. This study suggests that ileostomy confers significant morbidity particularly related to dehydration and renal impairment. |
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Bibliography: | Funding information JPB was funded through a locally funded academic clinical fellowship programme. Research materials were funded through charitable funding (Norwich Surgical Training and Research Academy). No other internal or external funding was provided Presentation at Society Meeting: Preliminary results from this review were presented as a poster at the 13th European Colorectal Congress of St Gallen, 1–5 December 2019, and was awarded 3rd prize. Registration: The review was registered with PROSPERO (CRD42019135695). ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1462-8910 1463-1318 |
DOI: | 10.1111/codi.15654 |