Postoperative outcomes and functional results after Deloyer's procedure – a retrospective cohort study

Abstract

Introduction The objective of our study was to describe surgical outcomes of Deloyers procedure in our referral center, and to compare the results of patients with and without protective ileostomy. Methods Patients undergoing a Deloyers procedure from 2013 to 2016 were prospectively included. General characteristics, intraoperative variables, postoperative course, and functional outcomes were analyzed. Patients were compared into two groups: group (1) patients undergoing Deloyers procedure without ileostomy, and group (2) Deloyers procedure with protective ileostomy. Results Sixteen patients undergoing isoperistaltic transposition of the right colon remnant were included, of which 9 (63%) were males with a median age of 47 (range 22–76) years. The main surgical indication was the restoration of bowel transit (62.5%). There was higher major morbidity rate in the Deloyers procedure with protective ileostomy group, but without statistical significance (20% vs. 9%, p = 0.92). No leaks or deaths were reported. The length of hospital stay was 7 days. The mean number of bowel movements per day was 4 at 18 months of follow up. Only four (25%) patients used irregularly loperamide. Conclusions The Deloyers procedure has satisfactory results and is reproducible with low morbidity. The major and minor morbidity rates were similar between groups, suggesting that the costs and risks of a second procedure can be avoided by providing a safe primary anastomosis.

Perforated mucocele of the appendix in the left upper quadrant: A challenging anatomy and an improvised surgical technique

“…A well-described scenario is when the resection involves most of the left colon and part of the transverse colon, and the remaining transverse colon does not reach the rectal stump. The following techniques have been described to overcome this challenge: Deloyers procedure [[12], [13], [14]]; the retroileal transmesenteric colorectal anastomosis [15,16]. These techniques emphasize the superiority of colorectal anastomosis over the easier-to-perform ileorectal anastomosis.…”

Deloyers procedure compared to ileorectal anastomosis as restoration techniques of bowel continuity after extended left colon resection

“…The DP consists of mobilization and rotation of the right colon remnant with the preservation of the ileocolic vessels and the ileocaecal valve to achieve a colorectal or coloanal anastomosis. A number of studies have addressed the role of DP and have established that it is a feasible option 32–35 …”

“…A number of studies have addressed the role of DP and have established that it is a feasible option. [32][33][34][35] We aimed to evaluate the outcomes of the DP in the short term (morbidity and mortality) and long-term (functionality and quality of life), comparing them with the outcomes of a group constituted by patients that underwent ileorectal anastomosis (IRA). To the best of our knowledge, there is no information about the functional outcomes and quality of life after DP.…”