@article{oai:shiga-med.repo.nii.ac.jp:00004116,
 author = {太田, 裕之 and 三宅, 亨 and 植木, 智之 and 小島, 正継 and 川崎, 誠康 and 龍田, 健 and 井内, 武和 and 神谷, 純広 and 清水, 智治 and 目片, 英治 and 谷, 眞至 and OHTA, Hiroyuki and MIYAKE, Toru and UEKI, Tomoyuki and KOJIMA, Masatsugu and KAWASAKI, Masayasu and TATSUTA, Takeshi and IUCHI, Takekazu and KAMITANI, Sumihiro and SHIMIZU, Tomoharu and MEKATA, Eiji and TANI, Masaji},
 journal = {International Journal of Colorectal Disease},
 month = {Jan},
 note = {pdf, 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., Journal Article},
 title = {Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)},
 year = {2022}
}