Recurrent Clostridium difficile Infection after Diverting Loop Ileostomy and Colonic Lavage: An Unreported Complication of the Novel Surgical Therapy

Abstract

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Diverting Loop Ileostomy for Clostridium Difficile Colitis: A Systematic Review and Meta-analysis

“…In addition, Neal et al reported only one case of CDI recurrence (2%) which was treated successfully with repeated lavage through the ileostomy. In contrast, Fashandi et al 13 reported CDI recurrence in 40% (n = 4) of the DLI group which occurred 1-7 months after surgery. All cases were successfully treated with vancomycin per ostomy or fecal transplant.…”

“…One final study was excluded as this particular article reported a reanalysis of the same patients in one of the other included studies. 13 Five studies contributed to the quantitative synthesis.…”

Fecal Microbiota Transplantation

“…23 Loop ileostomy may be a viable surgical alternative to total abdominal colectomy (TAC), but no clear survival benefit was demonstrated to date, 24 and with preservation of the colon recurrence of difficult-to-treat CDI is a concern. 25…”

“…23 Loop ileostomy may be a viable surgical alternative to total abdominal colectomy (TAC), but no clear survival benefit was demonstrated to date, 24 and with preservation of the colon recurrence of difficult-to-treat CDI is a concern. 25 Despite improved surgical techniques and predictive models, postsurgical mortality remains high. 23,26 The emergent nature of surgery or delay in surgical intervention after medical failure may contribute to this.…”