Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)
Purpose Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea afte...
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| Veröffentlicht in: | International journal of colorectal disease 2022-03, Vol.37 (3), p.657-664 |
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| container_title | International journal of colorectal disease |
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| creator | Ohta, Hiroyuki Miyake, Toru Ueki, Tomoyuki Kojima, Masatsugu Kawasaki, Masayasu Tatsuta, Takeshi Iuchi, Takekazu Kamitani, Sumihiro Shimizu, Tomoharu Mekata, Eiji Tani, Masaji |
| description | Purpose
Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery.
Methods
This prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups).
Results
A total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (
P
= 0.012 and
P
= 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (
P
= 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien–Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%,
P
= 0.0061).
Conclusions
Smoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications. |
| doi_str_mv | 10.1007/s00384-022-04097-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8885501</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714487222</galeid><sourcerecordid>A714487222</sourcerecordid><originalsourceid>FETCH-LOGICAL-c651t-74b5aee831dbaf9ade564ee8b0054a3c83249cd599234ce9ac06f85a12413a8f3</originalsourceid><addsrcrecordid>eNp9Ut1qFDEUDqLYtfoCXkjAmwqdmt-ZTC-EpagtFBSq1-FsJrNNmZmMyczCvojP61m3rlZEchFyvp_k5HyEvOTsjDNWvc2MSaMKJkTBFKurwjwiC66kKLgoxWOyYLyqC15rc0Se5XzH8FxW6ik5kpoZVspyQb5_Tr4JboopUxga6rowBAcdDf0IbqKxpWPMUxx9gilsPG0CpHTrgUI7-URd7GLybkKFg8FhJc9p7dP2nAIdU8wjgqg7pf3cTcH5AVWnNK6yTxt0jAMq8zQ3W3pyc3l1syx4ycSb5-RJC132L-73Y_L1w_svF5fF9aePVxfL68KVmk9FpVYavDeSNytoa2i8LhWeV4xpBdIZKVTtGl3XQirna3CsbI0GLhSXYFp5TN7tfcd51ftm97wEnR1T6CFtbYRgHyJDuLXruLHGGK0ZR4OTe4MUv80-T7YP2fmug8HHOVschKhLwSqN1Nd_Ue_inLD_HUsqbcoKh3dgraHzNgxtxHvdztQuEVemEkIg6-wfLFyN74OLg28D1h8IxF7gcCY5-fbQI2d2lya7T5PFNNmfabIGRa_-_J2D5Fd8kCD3hIzQgGP_3dJ_bH8A7TfWmw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2634586714</pqid></control><display><type>article</type><title>Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Ohta, Hiroyuki ; Miyake, Toru ; Ueki, Tomoyuki ; Kojima, Masatsugu ; Kawasaki, Masayasu ; Tatsuta, Takeshi ; Iuchi, Takekazu ; Kamitani, Sumihiro ; Shimizu, Tomoharu ; Mekata, Eiji ; Tani, Masaji</creator><creatorcontrib>Ohta, Hiroyuki ; Miyake, Toru ; Ueki, Tomoyuki ; Kojima, Masatsugu ; Kawasaki, Masayasu ; Tatsuta, Takeshi ; Iuchi, Takekazu ; Kamitani, Sumihiro ; Shimizu, Tomoharu ; Mekata, Eiji ; Tani, Masaji</creatorcontrib><description>Purpose
Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery.
Methods
This prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups).
Results
A total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (
P
= 0.012 and
P
= 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (
P
= 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien–Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%,
P
= 0.0061).
Conclusions
Smoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-022-04097-8</identifier><identifier>PMID: 35080636</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer ; Cancer surgery ; Colon cancer ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - complications ; Diarrhea ; Diarrhea - complications ; Diarrhea - etiology ; Digestive System Surgical Procedures - adverse effects ; Gastroenterology ; Hepatology ; Humans ; Hypertension ; Internal Medicine ; Medicine ; Medicine & Public Health ; Observational studies ; Oncology, Experimental ; Original ; Original Article ; Ostomy ; Patients ; Postoperative Complications - etiology ; Proctology ; Prospective Studies ; Rectal Neoplasms - surgery ; Rectum ; Retrospective Studies ; Risk factors ; Smoking ; Surgery ; Surgical Stomas</subject><ispartof>International journal of colorectal disease, 2022-03, Vol.37 (3), p.657-664</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c651t-74b5aee831dbaf9ade564ee8b0054a3c83249cd599234ce9ac06f85a12413a8f3</citedby><cites>FETCH-LOGICAL-c651t-74b5aee831dbaf9ade564ee8b0054a3c83249cd599234ce9ac06f85a12413a8f3</cites><orcidid>0000-0002-3318-9263</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-022-04097-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-022-04097-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35080636$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohta, Hiroyuki</creatorcontrib><creatorcontrib>Miyake, Toru</creatorcontrib><creatorcontrib>Ueki, Tomoyuki</creatorcontrib><creatorcontrib>Kojima, Masatsugu</creatorcontrib><creatorcontrib>Kawasaki, Masayasu</creatorcontrib><creatorcontrib>Tatsuta, Takeshi</creatorcontrib><creatorcontrib>Iuchi, Takekazu</creatorcontrib><creatorcontrib>Kamitani, Sumihiro</creatorcontrib><creatorcontrib>Shimizu, Tomoharu</creatorcontrib><creatorcontrib>Mekata, Eiji</creatorcontrib><creatorcontrib>Tani, Masaji</creatorcontrib><title>Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery.
Methods
This prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups).
Results
A total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (
P
= 0.012 and
P
= 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (
P
= 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien–Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%,
P
= 0.0061).
Conclusions
Smoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications.</description><subject>Cancer</subject><subject>Cancer surgery</subject><subject>Colon cancer</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - complications</subject><subject>Diarrhea</subject><subject>Diarrhea - complications</subject><subject>Diarrhea - etiology</subject><subject>Digestive System Surgical Procedures - adverse effects</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Observational studies</subject><subject>Oncology, Experimental</subject><subject>Original</subject><subject>Original Article</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectum</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Smoking</subject><subject>Surgery</subject><subject>Surgical Stomas</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9Ut1qFDEUDqLYtfoCXkjAmwqdmt-ZTC-EpagtFBSq1-FsJrNNmZmMyczCvojP61m3rlZEchFyvp_k5HyEvOTsjDNWvc2MSaMKJkTBFKurwjwiC66kKLgoxWOyYLyqC15rc0Se5XzH8FxW6ik5kpoZVspyQb5_Tr4JboopUxga6rowBAcdDf0IbqKxpWPMUxx9gilsPG0CpHTrgUI7-URd7GLybkKFg8FhJc9p7dP2nAIdU8wjgqg7pf3cTcH5AVWnNK6yTxt0jAMq8zQ3W3pyc3l1syx4ycSb5-RJC132L-73Y_L1w_svF5fF9aePVxfL68KVmk9FpVYavDeSNytoa2i8LhWeV4xpBdIZKVTtGl3XQirna3CsbI0GLhSXYFp5TN7tfcd51ftm97wEnR1T6CFtbYRgHyJDuLXruLHGGK0ZR4OTe4MUv80-T7YP2fmug8HHOVschKhLwSqN1Nd_Ue_inLD_HUsqbcoKh3dgraHzNgxtxHvdztQuEVemEkIg6-wfLFyN74OLg28D1h8IxF7gcCY5-fbQI2d2lya7T5PFNNmfabIGRa_-_J2D5Fd8kCD3hIzQgGP_3dJ_bH8A7TfWmw</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Ohta, Hiroyuki</creator><creator>Miyake, Toru</creator><creator>Ueki, Tomoyuki</creator><creator>Kojima, Masatsugu</creator><creator>Kawasaki, Masayasu</creator><creator>Tatsuta, Takeshi</creator><creator>Iuchi, Takekazu</creator><creator>Kamitani, Sumihiro</creator><creator>Shimizu, Tomoharu</creator><creator>Mekata, Eiji</creator><creator>Tani, Masaji</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3318-9263</orcidid></search><sort><creationdate>20220301</creationdate><title>Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)</title><author>Ohta, Hiroyuki ; Miyake, Toru ; Ueki, Tomoyuki ; Kojima, Masatsugu ; Kawasaki, Masayasu ; Tatsuta, Takeshi ; Iuchi, Takekazu ; Kamitani, Sumihiro ; Shimizu, Tomoharu ; Mekata, Eiji ; Tani, Masaji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c651t-74b5aee831dbaf9ade564ee8b0054a3c83249cd599234ce9ac06f85a12413a8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer</topic><topic>Cancer surgery</topic><topic>Colon cancer</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - complications</topic><topic>Diarrhea</topic><topic>Diarrhea - complications</topic><topic>Diarrhea - etiology</topic><topic>Digestive System Surgical Procedures - adverse effects</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Observational studies</topic><topic>Oncology, Experimental</topic><topic>Original</topic><topic>Original Article</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectum</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Smoking</topic><topic>Surgery</topic><topic>Surgical Stomas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohta, Hiroyuki</creatorcontrib><creatorcontrib>Miyake, Toru</creatorcontrib><creatorcontrib>Ueki, Tomoyuki</creatorcontrib><creatorcontrib>Kojima, Masatsugu</creatorcontrib><creatorcontrib>Kawasaki, Masayasu</creatorcontrib><creatorcontrib>Tatsuta, Takeshi</creatorcontrib><creatorcontrib>Iuchi, Takekazu</creatorcontrib><creatorcontrib>Kamitani, Sumihiro</creatorcontrib><creatorcontrib>Shimizu, Tomoharu</creatorcontrib><creatorcontrib>Mekata, Eiji</creatorcontrib><creatorcontrib>Tani, Masaji</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ohta, Hiroyuki</au><au>Miyake, Toru</au><au>Ueki, Tomoyuki</au><au>Kojima, Masatsugu</au><au>Kawasaki, Masayasu</au><au>Tatsuta, Takeshi</au><au>Iuchi, Takekazu</au><au>Kamitani, Sumihiro</au><au>Shimizu, Tomoharu</au><au>Mekata, Eiji</au><au>Tani, Masaji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>37</volume><issue>3</issue><spage>657</spage><epage>664</epage><pages>657-664</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery.
Methods
This prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups).
Results
A total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (
P
= 0.012 and
P
= 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (
P
= 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien–Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%,
P
= 0.0061).
Conclusions
Smoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35080636</pmid><doi>10.1007/s00384-022-04097-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3318-9263</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of colorectal disease, 2022-03, Vol.37 (3), p.657-664 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Cancer Cancer surgery Colon cancer Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - complications Diarrhea Diarrhea - complications Diarrhea - etiology Digestive System Surgical Procedures - adverse effects Gastroenterology Hepatology Humans Hypertension Internal Medicine Medicine Medicine & Public Health Observational studies Oncology, Experimental Original Original Article Ostomy Patients Postoperative Complications - etiology Proctology Prospective Studies Rectal Neoplasms - surgery Rectum Retrospective Studies Risk factors Smoking Surgery Surgical Stomas |
| title | Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602) |
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