Satisfactory short-term outcome of total laparoscopic loop ileostomy reversal in obese patients: a comparative study with open techniques

Su, Hao; Luo, Shou; Zheng, Xu; Zhao, Chenyang; Bao, Mandula; Wang, Xishan; Zhou, Zhixiang; Zhou, Haitao

doi:10.1007/s13304-020-00890-8

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…In contrast, we observed an overall 10.77% rates of complications, and the majority were transient fever and incisional infection. Similarly, our previous study also reported a 10% incidence of postoperative complications associated with TLAP reversal in obese patients (9), whereas the open technique carried an increased incidence of incisional infection (26.5%). In summary, these results indicated the advantage of TLAP in reducing postoperative complications, which may be highlighted by further prospective and randomized multicenter studies.…”

Section: Discussionsupporting

confidence: 68%

“…With the evolution of minimally invasive techniques, laparoscopic-assisted reversal has been developed to reduce postoperative complications such as bowel obstruction and incisional hernia (5,6). In addition, some initial explorations of laparoscopic reversal with intracorporeal anastomosis have been conducted (7)(8)(9). However, intracorporeal intestine reconstruction is relatively difficult and requires a learning process for inexperienced surgeons.…”

Section: Introductionmentioning

confidence: 99%

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A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

Zheng

Zhang

et al. 2023

Front. Surg.

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PurposeRecently, totally laparoscopic ileostomy reversal (TLAP) has received increasing attention and exhibited promising short-term outcomes. The aim of this study was to detail the learning process of the TLAP technique.MethodsBased on our initial experience with TLAP from 2018, a total of 65 TLAP cases were enrolled. Demographics and perioperative parameters were assessed using cumulative sum (CUSUM), moving average, and risk-adjusted CUSUM (RA-CUSUM) analyses.ResultsThe overall mean operative time (OT) was 94 min and the median postoperative hospitalization period was 4 days, and there was an estimated 10.77% incidence rate of perioperative complications. Three unique phases of the learning curve were derived from CUSUM analysis, and the mean OT of phase I (1–24 cases) was 108.5 min, that of phase II (25–39 cases) was 92 min, and that of phase III (40–65 cases) was 80 min, respectively. There was no significant difference in perioperative complications between these 3 phases. Similarly, moving average analysis indicated that the operation time was reduced significantly after the 20th case and reached a steady state after the 36th case. Furthermore, complication-based CUSUM and RA-CUSUM analyses indicated an acceptable range of complication rates during the whole learning period.ConclusionOur data demonstrated 3 distinct phases of the learning curve of TLAP. For an experienced surgeon, surgical competence in TLAP can be grasped at around 25 cases with satisfactory short-term outcomes.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

Zheng

Zhang

et al. 2023

Front. Surg.

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“…In recent decades, laparoscopic techniques have become increasingly widely applied in gastrointestinal surgery[ 15 , 16 ]. LIR has also attracted the attention of surgeons because this procedure is associated with earlier gastrointestinal recovery, shorter postoperative hospital stay, and lower complication rates[ 17 , 18 ]. However, CD is characterized by extensive intestinal inflammation and thickening of the mesentery and blood vessels, which pose significant risks and difficulties in laparoscopic surgery[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic vs open surgery in ileostomy reversal in Crohn’s disease: A retrospective study

Wan¹,

Yuan²,

Wu³

et al. 2021

WJGS

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BACKGROUND Although minimally invasive surgery is becoming more commonly applied for ileostomy reversal (IR), there have been relatively few studies of IR for patients with Crohn's disease (CD). It is therefore important to evaluate the potential benefits and risks of laparoscopy for patients with CD. AIM To compare the safety, feasibility, and short-term and long-term outcomes of laparoscopic IR (LIR) vs open IR (OIR) for the treatment of CD. METHODS The baseline characteristics, operative data, and short-term (30-d) and long-term outcomes of patients with CD who underwent LIR and OIR at our institution between January 2017 and January 2020 were retrieved from an electronic database and retrospectively reviewed. RESULTS Of the 60 patients enrolled in this study, LIR was performed for 48 and OIR for 12. There were no statistically significant differences in baseline characteristics, operation time, intraoperative blood loss, days to flatus and soft diet, postoperative complications, hospitalization time, readmission rate within 30 d, length of hospitalization, hospitalization costs, or reoperation rate after IR between the two groups. However, patients in the LIR group more frequently required lysis of adhesions as compared to those in the OIR group (87.5% vs 41.7%, respectively, P < 0.05). Notably, following exclusion of patients who underwent enterectomy plus IR, OIR was more advantageous in terms of postoperative recovery of gastrointestinal function and hospitalization costs. CONCLUSION The safety and feasibility of LIR for the treatment of CD are comparable to those of OIR with no increase in intraoperative or postoperative complications.

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“…In the era of minimally invasive surgery, some have tried to perform stoma reversal surgery laparoscopically. 2,3 The adhesion around the stoma inside the body can be more easily released with laparoscopy. However, while performing bowel anastomosis intracorporeally, peritoneal cavity contamination is possible.…”

Section: Introductionmentioning

confidence: 99%

“…In the era of minimally invasive surgery, some have tried to perform stoma reversal surgery laparoscopically 2,3 . The adhesion around the stoma inside the body can be more easily released with laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

Optimizing stoma closure: A laparoscopic technique yielding the least contamination

Jong,

Chern,

You

2024

World j. surg.

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In this study, we introduce a novel method for stoma closure, aiming to reduce wound infection rates. This method involves creating the common channel of both limbs of a loop stoma extracorporeally, which is particularly beneficial during laparoscopic stoma closure surgery by potentially avoiding contamination of the wound. We applied this technique in 23 patients undergoing laparoscopic stoma reversal surgery, comprising both loop colostomy and ileostomy cases. Notably, postoperative outcomes were promising: only two patients experienced postoperative ileus, and importantly, there were no instances of wound infection. These findings suggest that our laparoscopic stoma reversal surgery approach is not only safe and feasible but also offers a significant advantage in reducing wound infection rates.

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Satisfactory short-term outcome of total laparoscopic loop ileostomy reversal in obese patients: a comparative study with open techniques

Cited by 7 publications

References 22 publications

A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

Laparoscopic vs open surgery in ileostomy reversal in Crohn’s disease: A retrospective study

Optimizing stoma closure: A laparoscopic technique yielding the least contamination

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