Comparison of transanal stent with defunctioning stoma in low anterior resection for rectal cancer

Amin, A.I.; Ramalingam, Theebanraja; Sexton, Rosemary; Heald, R. J.; Leppington-Clarke, A; Moran, Brendan

doi:10.1002/bjs.4074

Cited by 72 publications

(49 citation statements)

References 4 publications

(8 reference statements)

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“…The technique can be used with newer curvilinear staplers, although the placement of two devices side by side in the modified technique is easier with linear devices. 20 The rarity of intramural downward spread of rectal cancer has enabled surgeons to preserve the anal sphincter mechanism in many more patients than was possible a decade ago [1,2,14,17]. Undoubtedly stapling technology has facilitated satisfactory low reconstructions and reduced by one-half to three-quarters the proportion of patients who require permanent colostomy.…”

Section: Discussionmentioning

confidence: 97%

Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer

et al. 2007

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Section: Discussionmentioning

confidence: 97%

Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer

et al. 2007

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“…By doing this, inflammation at the anastomotic wound can be decreased due to a reduction of infection sources. Several tube-structured devices have been attempted to replace the temporary stoma [7][8][9][10][11]; however, they have not been successful. Their limitations, such as limited maintenance duration, incontinence, and questionable safety, may be the main cause of this failure.…”

mentioning

confidence: 99%

Fecal diverting device for the substitution of defunctioning stoma: preliminary clinical study

Kim

Jung

2018

Surg Endosc

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Background A novel fecal diverting device (FDD) made for the prevention of sepsis resulting from anastomotic leakage (AL) was tested successfully in an animal study. This study was undertaken to evaluate the clinical safety and effectiveness of the FDD. Methods A prospective observation trial was implemented in a tertiary referral university hospital. The study enrolled patients who needed a defunctioning stoma to preserve low-lying rectal anastomosis. The FDD was fixed to the proximal colon 15 cm from the anastomosis and scheduled to divert feces for 3 weeks. The duration could be extended for more than 3 weeks if AL was noted. Postoperative evaluations of AL were performed by obtaining a computed tomography (CT) scan after 1 week and a contrast study after 3 weeks. The outcomes were FDD-related complications, and the capacity of the FDD to preserve the anastomosis. The median follow-up period was 10 (range 5-40) months. Results Thirty-one patients, including 5 benign cases, were evaluated. There was no case of stoma conversion or surgical re-intervention. Evidence of AL was identified in 10 (32%) patients using the CT scan at 1 week after surgery. However, in the contrast study at 3 weeks after surgery, only 5 cases of AL sinus were noted. Conservative treatments including 1-3 weeks prolongation of FDD maintenance were enough to preserve the anastomosis. There were 3 cases of partial colonic wall erosions at the FDD attachment area. All of these patients showed improvement with conservative treatment. The limitations were that the study was performed in a single institute and without a control group. Conclusions The FDD showed a sufficient capacity of fecal diversion and maintenance duration that prevented aggravation of sepsis in the case of AL without significant complications.

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“…The Foley cather should be of large bore and irrigation can be carried out if necessary. The Heald stent has been previously demonstrated to be an alternative, though not foolproof, method of avoiding a defunctioning loop stoma in low rectal anastomoses 3 , however is still used routinely after high anterior resections at some centers. We recommend this technique of allowing free rectal luminal drainage via the Heald stent in combination with a Foley catheter to allow presacral drainage of postop collections at the site of low colorectal anastamoses.…”

Section: Discussionmentioning

confidence: 99%

Double Decompression of Presacral Collection by Heald Anal Stent and Foley Catheter Combination

Godfrey

Nash

2011

Surgical Techniques Development

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The authors demonstrate the effective drainage of presacral sepsis following low anterior resection surgery using the novel approach of both the Heald anal stent and a Foley catheter combined. The Heald stent was placed trans-anally without the need for anaesthetic and an 18Fr Foley was placed through this. A presacral collection was drained through the stent, allowing the patient to be discharged after a week without the need to return to the operating theatre. The Heald stent may be used to successfully drain a presacral collection by double decompression of the rectum and the presacral space

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Comparison of transanal stent with defunctioning stoma in low anterior resection for rectal cancer

Abstract: Stent is a potential alternative to a stoma

Cited by 72 publications

References 4 publications

Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer

Long-term results show triple stapling facilitates safe low colorectal and coloanal anastomosis and is associated with low rates of local recurrence after anterior resection for rectal cancer

Fecal diverting device for the substitution of defunctioning stoma: preliminary clinical study

Double Decompression of Presacral Collection by Heald Anal Stent and Foley Catheter Combination

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