BACKGROUND 29% of post-ileostomy discharges are readmitted, most commonly due to dehydration. However, there is a lack of detailed data specifically evaluating factors associated with readmission with dehydration. Additionally, patients with a history of an ileostomy have often been excluded from previous studies, and therefore represent a group of understudied ileostomates. OBJECTIVE To evaluate factors available at discharge associated with 30-day readmission for dehydration, rather than all-cause readmissions. DESIGN This was a retrospective cohort study. SETTING Study patients received ileostomies at a tertiary academic medical center from 2014–2016. PATIENTS Patients with a pre-existing ileostomy which was not recreated per the operative note were excluded, while those who received a new ileostomy were included. MAIN OUTCOME MEASURE 30-day readmission for dehydration as defined by objective clinical criteria. RESULTS A total of 262 patients underwent ileostomy creation and were discharged alive. 25% were aged ≥65, 53% were male, 14% had a history of ileostomy, 18% had a creatinine >1.0 on discharge, and 26% had high ileostomy output at any time during the index admission. Among all ileostomates, the all-cause rate was 30%. Mean days to readmission for any cause was 8.5 while for dehydration it was 11.6 days. Of the readmissions, 37% were readmitted with a diagnosis of dehydration, and dehydration was the sole reason in 26%. Among those with dehydration, the most common length of stay was 2 days. In multivariable logistic regression, 30-day readmission with dehydration was associated with older age, male sex, history of an ileostomy, high ileostomy output during index admission, and a discharge creatinine >1.0. LIMITATIONS Retrospective design. CONCLUSIONS Ileostomy dehydration efforts have focused on new ileostomy patients; however, our data suggests that patients with a history of an ileostomy are actually at risk for readmission with dehydration. Further studies aimed at reduction of readmission with dehydration after ileostomy are warranted and should include patients with a history of an ileostomy. See Video Abstract at http://links.lww.com/DCR/A643.

Prostate cancer, symptomatic haemorrhoids, perianal sepsis, rectal cancer and a history of restorative rectal resection were common associations with FI in men. The aetiologies for FI in men vary with age.

A perineal approach is safer than an abdominal approach to the treatment of rectal prolapse. Regarding an abdominal operation, rectopexy has fewer major complications than resection.

This technical note describes the surgical technique of graciloplasty as an option for the treatment of rectovaginal, rectourethral and rectovesical fistulas.

The surgical formation of an ileostomy has physiological sequelae that are incompletely understood. It is known that these patients are susceptible to dehydration in the early postoperative period and that dehydration contributes to their high readmission rates [1,2]. However, the literature on this subject is complicated by several definitions of dehydration of varying quality. The most