Should routine contrast study be a norm before stoma reversal? A retrospective study of patients with temporary ileostomy

Saini, Pradeep; Gupta, Praanjal; Sharma, Ashish; Agarwal, Nitin; Kaur, Navneet; Gupta, Arun

doi:10.1177/0049475513489827

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Although the literature supports the sensitivity and positive predictive value of WSCE in detecting anastomotic leaks, several studies have questioned the utility of WSCE in routine clinical practice. [134][135][136][137][138][139][140][141][142][143][144][145] Dimitriou et al 134 performed a WSCE on 339 patients after low pelvic anastomosis before ostomy reversal and identified 24 patients (7.1%) with an anastomotic leak. Of these patients, only 29% had an uncomplicated postoperative course from their index procedure, indicating that, in most cases, the surgeon could have a clinical suspicion of which patients were at highest risk of poorly healed anastomosis.…”

Section: Routine Water-soluble Contrast Studies In the Absence Of A C...mentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

Davis

Valente

Goldberg

et al. 2022

Diseases of the Colon &Amp; Rectum

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Section: Routine Water-soluble Contrast Studies In the Absence Of A C...mentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

Davis

Valente

Goldberg

et al. 2022

Diseases of the Colon &Amp; Rectum

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Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal

Raza,

Talpur,

Khatti

et al. 2024

PJHS

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The Distal loopogram assesses distal bowel health pre-stoma reversal. Yet, its benefits for typhoid perforation patients require further evaluation. Objective: To assess the utility of distal loopogram before the ileostomy stoma reversal in patients of typhoid perforation. Methods: A comparative, cross-sectional study was conducted upon a sample of 76 patients of both gender with age from 13 to 70 years and being operated for reversal of post-typhoid perforation loop ileostomy with or without distal loopogram study at Liaquat University Hospital Jamshoro and Hyderabad. Non-consenting patients and the patients with deranged kidney function or comorbid conditions in which contrast material is contraindicated or patients allergic to contrast agent or having tendency of atopy to any allergens like patients of bronchial asthma and those who lost to follow up were excluded from the sample. Results: The loopogram accurately predicted anastomotic leakage and mucocutaneous separation in all cases during surgery. Bowel stricture was predicted in 66.7% of cases, and peristomal dermatologic problems in 50%. This highlights the loopogram's utility in anticipating surgical challenges, especially for critical issues like anastomotic leakage and mucocutaneous separation. Conclusions: It was concluded that distal loopogram was valuable for assessing post-typhoid ileostomy reversal patients, offering detailed small intestine images for identifying complications and enhancing surgical planning, thus improving outcomes

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Factors Influencing Morbidity and Mortality of Elective Stoma Closure

Pandey¹,

Kaushik²,

Singh³

et al. 2018

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Background: Stoma are often created in the emergency. These patients usually undergo restoration of bowel continuity electively 10 to 12 weeks later. Material and Methods: Patients undergoing elective stoma closure were followed up for 3 months post-operatively for any morbidity (or mortality). Various patient and surgeon variables were analyzed to define factors that could affect the outcome of bowel restoration. Results: Of the 80 patients included, 62 were male (77.5%) and 18 (22.5%) female with an average age of 37.8 years. The commonest indication of stoma creation was peritonitis (52.5%); all patients underwent restoration after an average duration of 161.1 days. 47 patients (58.8%) developed 62 morbidity events-commonly, wound infection (47.5%), anastomotic leak (15%) and early post-operative ileus (6.25%). There were 4 deaths (5%). Univariate analysis revealed significantly higher rate of anastomotic leakin patients with low BMI, low hemoglobin, low albumin, laparotomy for restoration, and American Society of Anesthesiology (ASA) grade III.-Post-operative obstruction was significantly associated with delay in closure, laparotomy, ASA grade III , and when consultants performed restoration. Mortality was significantly higher in patients with age above 55 years, low BMI, ASA grade III, low pre-operative hemoglobin and after anastomotic leak. Conclusion: Restoration is not an innocuous procedure; significant morbidity and mortality is associated with it. Proper timing of closure as well as optimizing the patient help in reducing the morbidity and mortality of the operation.

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Should routine contrast study be a norm before stoma reversal? A retrospective study of patients with temporary ileostomy

Cited by 3 publications

References 8 publications

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal

Factors Influencing Morbidity and Mortality of Elective Stoma Closure

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