Tsujinaka S, Suzuki H, Miura T, Sato Y, Shibata C. Obstructive and secretory complications of diverting ileostomy. World J Gastroenterol 2022; 28(47): 6732-6742 [PMID: 36620340 DOI: 10.3748/wjg.v28.i47.6732]
Corresponding Author of This Article
Shingo Tsujinaka, MD, Associate Professor, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Miyagi, Japan. tsujinakas@tohoku-mpu.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Miyagi, Japan
Author contributions: Tsujinaka S wrote the manuscript; Suzuki H, Miura T and Sato Y reviewed the manuscript and agreed with submission; Shibata C critically reviewed the manuscript and agreed with submission.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shingo Tsujinaka, MD, Associate Professor, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Miyagi, Japan. tsujinakas@tohoku-mpu.ac.jp
Received: September 20, 2022 Peer-review started: September 20, 2022 First decision: October 21, 2022 Revised: November 4, 2022 Accepted: November 25, 2022 Article in press: November 25, 2022 Published online: December 21, 2022
Core Tip
Core Tip: This review highlights the etiology, diagnosis, treatment, and prevention of obstructive and secretory complications associated with diverting ileostomy (DI). Obstructive complications at the stoma site (stoma outlet obstruction/stoma-related obstruction, SOO/SRO) affect 5.4%-27.3% of patients with DI. Trans-stomal tube decompression is effective in most cases. Surgical refinement is important for reducing SOO/SRO. Secretory complications (high output stoma, HOS) lead to water and sodium depletion and secondary hyperaldosteronism with electrolyte imbalances. The incidence of HOS is 14%-24%, with an output of 1000-2000 mL/d. HOS treatment includes fluid intake restriction, antimotility and antisecretory drug therapies, and magnesium supplementation. Intensive monitoring and surveillance programs may decrease the readmission rates for dehydration.
