The effect of a diverting ileostomy formation on nutritional status and energy intake of patients undergoing colorectal surgery.

Athanasios Migdanis, Georgios Koukoulis, Ioannis Mamaloudis, Ioannis Baloyiannis, Ioannis Migdanis, Xanthoula Vagena, Eleni Malissiova, Georgios Tzovaras

Journal: Clinical nutrition ESPEN 2021;40():357-362

PMID: 33183563

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND AND AIMS

The effects of ileostomy construction and colonic bypass on the general nutritional status of the patients have not yet received much attention. The aim of the present study was to assess the effect of a diverting ileostomy formation, on the nutritional intake, body composition and nutritional status biochemical markers of patients with a newly formed ileostomy.

METHODS

This was an observational study. Patients scheduled for elective rectosigmoid resection at a surgical unit of a public university hospital, were considered for study inclusion. Patients in whom a diverting ileostomy was created were assigned to the ileostomy group (n = 41), and patients who underwent rectosigmoid resection without requiring a diverting ileostomy served as a control group (n = 37). Anthropometric characteristics, body composition, dietary intake and biochemical markers representative of nutritional status were assessed preoperatively and at 40 days postdischarge (NCT02036346).

RESULTS

Anthropometric and body composition characteristics (weight, BMI and body fat percentage) significantly declined from 75 to 71.6 kg, 26.9 to 25.6 kg/m and 28.6 to 25.6% respectively (p = 0.001 for all) in the ileostomy group, between the preoperative stage and 40 days postdischarge from the hospital. Furthermore, a significant reduction in mean daily energy intake from 1871 to 1713 kcal/day (p = 0.046) was observed in the ileostomy group 40 days after discharge compared to preoperative assessment. No significant changes in the above measured parameters were observed in the non-ileostomy group.

CONCLUSION

Diverting ileostomy can have a negative effect on general nutritional status and dietary intake of patients, during the first postoperative period. Nutritional assessment might need to be included in the routine clinical management of this patient category to prevent weight loss and impaired energy intake.

Address: Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, Larissa 41110, Greece; Department of Nutrition and Dietetics, University of Thessaly, Terma Mauromixali, Karditsa 43100, Greece. Electronic address: [email protected].; Department of General Surgery, General Hospital of Larissa, Tsakalof 1, Larissa 41221, Greece. Electronic address: [email protected].; Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. Electronic address: [email protected].; Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, Larissa 41110, Greece; Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. Electronic address: [email protected].; Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, Larissa 41110, Greece; Department of Nutrition and Dietetics, University of Thessaly, Terma Mauromixali, Karditsa 43100, Greece. Electronic address: [email protected].; Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, Larissa 41110, Greece. Electronic address: [email protected].; Department of Food Science and Nutrition, University of Thessaly, Terma Temponera, Karditsa 43100, Greece. Electronic address: [email protected].; Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, Larissa 41110, Greece; Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. Electronic address: [email protected].

DOI: 10.1016/j.clnesp.2020.08.002

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MeSH Terms: Aftercare, Colorectal Surgery, Energy Intake, Humans, Ileostomy, Nutritional Status, Patient Discharge