Loop ileostomy after heal pouch-anal anastomosis—Is it necessary?

Winslet, M. C.; Barsoum, G; Pringle, W.; Fox, Katherine; Keighley, M. R. B.

doi:10.1007/bf02090168

Cited by 55 publications

(33 citation statements)

References 13 publications

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“…The percentage of patients who suffered from complications (18%) due to the ileostomy closure is in line with previous reports [5, 9, 16, 17, 22]. During follow-up, 5 incisional hernias (8%) at the site of the previous stoma were seen.…”

Section: Discussionsupporting

confidence: 76%

“…However, after construction of the ileostomy, many patients (42%) experienced stoma-related complications. In the literature, this percentage ranges from 9 to 74% [5, 9, 17, 20, 23, 24, 25]. These complications enhance the adverse effect of an ileostomy per se on the quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…A loop ileostomy probably does not reduce the incidence of anastomotic leakage, but rather decreases the detrimental effects once leakage occurs [10, 11, 12, 13, 14]. In general, closure is not planned earlier than 8–12 weeks after construction [15, 16, 17]. Because ileostomy closure does not have a high medical priority in an era of stringent financial budgeting, this operation is often postponed [5].…”

Section: Introductionmentioning

confidence: 99%

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Morbidity of Temporary Loop Ileostomies

et al. 2004

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Background/Aims: A temporary loop ileostomy is constructed to protect a distal colonic anastomosis. Closure is usually performed not earlier than 8–12 weeks after the primary operation. During this period, stoma-related complications can occur and enhance the adverse effect on quality of life. The aim of this study was to evaluate the length of time between ileostomy construction and closure, to quantify stoma-related morbidity and to examine the potential advantages of early ileostomy closure. Methods: Sixty-nine patients with a temporary, protective loop ileostomy (constructed between January 1996 and December 2000) were retrospectively analysed. The analysis was done by reviewing the medical records and the notes of the stoma care nurse. Results: Sixty ileostomies (87%) were closed after a median period of 24 weeks (range 2–124 weeks). Stoma-related complications occurred in 29 of the 69 patients (42%), and 11 patients (18%) had complications after ileostomy closure. Conclusion: The length of time between ileostomy construction and closure was substantially longer than initially planned. Earlier ileostomy closure (preferably even during the initial admission) could reduce the frequently occurring stoma-related morbidity in these patients and thus improve quality of life.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Morbidity of Temporary Loop Ileostomies

et al. 2004

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“…The median time for planned conventional closure in our series was 213 days. During this time, up to 40 % of patients have stoma-related complications [8,9,25,26], and 70 % have stoma care problems [9]. Early ileostomy closure may prevent the physical and psychological morbidity, as well as decreased quality of life and limit the costs associated with defunctioning ileostomy [9,10,18,27,28].…”

Section: Discussionmentioning

confidence: 99%

Facilitated early ileostomy closure after rectal cancer surgery: a case-matched study

et al. 2012

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“…However, the ileostomy itself and its closure may be a source of significant complications (10,(29)(30)(31)(32)(33)(34)(35). Moreover, ileostomy closure prolongs total hospital stay (29,30).…”

Section: Temporary Diverting Ileostomymentioning

confidence: 99%

Clinical and Physiological Aspects of Ileal Pouch-Anal Anastomosis

Salemans

Nagengast

1995

Scandinavian Journal of Gastroenterology

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Salemans JMJI, Nagengast FM. Clinical and physiological aspects of ileal pouch-anal anastomosis. Scand J Gastroenterol 1995;30 Suppl 212:3-12.Proctocolectom y with ileal pouch-anal anastomosis is the surgical treatment of choice for severe chronic ulcerative colitis and familial polyposis coli because the entire colonic mucosa is removed while anal function can be preserved and the necessity for permanent ileostomy is eliminated. Long-term functional results are generally gratifying, as defecation frequency and degree of incontinence are acceptable in most patients. Pouchitis, however, a non-specific inflammation of the ileal reservoir, is a major long-term complication occurring in a considerable number o f patients. The etiology of pouchitis is unknown. Since pouchitis occurs more frequently or even exclusively in ulcerative colitis patients it is assumed that pouchitis is a novel manifestation o f inflammatory bowel disease. However, bacterial overgrowth in the ileal pouch may also play a pathogenetic role. Chronic inflammation and villous atrophy o f varying severity is found in virtually all pouches. Acute inflammatory changes and ulceration are associated with pouchitis.

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Loop ileostomy after heal pouch-anal anastomosis—Is it necessary?

Cited by 55 publications

References 13 publications

Morbidity of Temporary Loop Ileostomies

Morbidity of Temporary Loop Ileostomies

Facilitated early ileostomy closure after rectal cancer surgery: a case-matched study

Clinical and Physiological Aspects of Ileal Pouch-Anal Anastomosis

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