Stoma prolapse handmade repair under local anesthesia with variation of Altemeier method in severe patients: a case report and review of the literature

Papadopoulos, V. N.; Bangeas, Petros; Xanthopoulou, Kassandra; Paramythiotis, Daniel; Michalopoulos, Antonios

doi:10.1093/jscr/rjx027

Cited by 14 publications

(15 citation statements)

References 8 publications

(14 reference statements)

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“…Several local surgical techniques for treating stomal prolapse have been reported previously [3][4][5][6][7][8][9][10][11][12][13][14][15][16], but most reports have been case series with no more than 10 patients. The largest number of patients in a previous report was 25, with surgery performed by Koide et al using staplers [13]; only one patient suffered recurrent stomal prolapse within a year after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several reports of such local surgical methods, but no large-scale studies have been performed previously, and the outcome of local surgery for stomal prolapses is 2 of 7 unclear. In terms of the principal surgical methods, a few case series have been reported involving the application of Altemeier's procedure for rectal prolapse [3][4][5] and methods using staplers [6][7][8][9][10][11][12][13][14]. In both methods, the intestine that has prolapsed through the stoma is excised at a level external to the abdominal wall; the stoma is then reconstructed.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Outcome of Local Surgery for Stomal Prolapse

Kosuge

Ohkuma

Koyama

et al. 2021

JCM

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We reviewed the results of local surgical treatment of stoma prolapse, a long-term complication of stoma construction. Fifteen patients treated for stomal prolapse between 2009 and 2020 at the authors’ and affiliated hospitals were included in this study. The treatment comprised local laparotomic stomal reconstruction (LLSR) in nine patients and stapling repair (SR) in six. We compared and evaluated the clinical and surgical information and postoperative complications. Operation time was significantly shorter in the SR group than in the LLSR group: 20 and 53 min, respectively (p = 0.036). The duration of postoperative hospitalization was shorter in the SR group than in the LLSR group: 5.5 and 8 days, respectively; the difference was not significant (p = 0.088). No short-term complications were found in either group. Regarding long-term, postoperative complications, parastomal hernias developed after 2.5 years in one patient in the LLSR group and after 6 months in one patient in the SR group; both patients had histories of parastomal hernia surgery and had relatively high body mass indices. Local surgery for stomal prolapse was minimally invasive and performed safely. In patients with a history of surgery for parastomal hernia, attention must be paid to the potential of parastomal hernia developing as a postoperative complication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of the Outcome of Local Surgery for Stomal Prolapse

Kosuge

Ohkuma

Koyama

et al. 2021

JCM

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“…27,31 Most repairs and revisions of ostomies for prolapse are often possible with sedation and local anesthesia alone. 32…”

Section: Stomal Prolapsementioning

confidence: 99%

Ostomy Complications in Crohn's Disease

Aboulian

2019

Clinics in Colon and Rectal Surgery

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Ostomy creation is a routine surgical procedure that has earned its place high in the surgeon's armamentarium in dealing with challenging situations. However, it is not without its complications. In this article, we review the common complications including parastomal hernia, prolapse, mucocutaneous junction separation with ischemia and stenosis, peristomal skin conditions, and infections. Additionally, we review conditions that arise in association with underlying Crohn's disease, such as peristomal inflammation, fistula formation, and pyoderma gangrenosum.

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“…The Altemeier technique is a well-known transperineal procedure for full-thickness rectal prolapse [ 15 ]. A modification of this technique, the modified Altemeier technique (MAT), has been used for local repair of SP [ 11 - 12 ]. This procedure is technically simple, consists of prolapsed bowel resection with anastomosis using sutures alone, and is applicable by surgeons with any level of expertise.…”

Section: Introductionmentioning

confidence: 99%

Mid-term Efficacy of Local Repair Using Modified Altemeier Technique for Stomal Prolapse: A Case Series

Tsujinaka¹,

Kakizawa²,

Hatsuzawa³

et al. 2022

Cureus

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Introduction: Stomal prolapse (SP) is characterized by full-thickness protrusion of the bowel through the stoma site. The surgical procedures for SP include local repair, abdominal wall fixation, and stoma relocation. However, previous reports were mostly case reports or case series with a small number of patients and lacked long-term results. A modified Altemeier technique (MAT) has been used for the local repair of SP in our institution, and this study aimed to evaluate its mid-term efficacy. Methods: We reviewed patients who underwent MAT for SP between August 2013 and December 2020. The variables included patient characteristics, type of stoma, indications of stoma creation, the time interval from stoma creation to prolapse, site of prolapse, reasons for SP surgery, perioperative variables, complications during SP surgery, and length of follow-up. Recurrence of SP was defined as the need for change in stoma care or re-protrusion of the stoma by more than 5 cm in length. Results: Ten patients were included in this study. The median age at the time of SP surgery was 71.5 years. The indications of stoma creation included unresectable or recurrent intra-abdominal malignancies in four patients, diverting ileostomy with rectal cancer surgery in two, transverse colon cancer in one, gastric and rectal cancer in one, rectovaginal fistula in one, and non-occlusive mesenteric ischemia in one. The median interval from stoma creation to prolapse was 2.5 months. Six patients underwent elective SP surgery, and four patients underwent emergency surgery for incarcerated prolapse. The median operative time was 75.5 min. Postoperative complications that included transient mucosal ischemia and subcutaneous abscess occurred in one patient. There were four recurrences (40%), and the median time interval from surgery to recurrence was 4.5 months. Two patients underwent repeated MAT, one of whom underwent stomal reversal with laparotomy for re-recurrence. The median follow-up duration was 19 months. Conclusion: MAT for SP is associated with a high recurrence rate in mid-term follow-up.

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Stoma prolapse handmade repair under local anesthesia with variation of Altemeier method in severe patients: a case report and review of the literature

Cited by 14 publications

References 8 publications

Evaluation of the Outcome of Local Surgery for Stomal Prolapse

Evaluation of the Outcome of Local Surgery for Stomal Prolapse

Ostomy Complications in Crohn's Disease

Mid-term Efficacy of Local Repair Using Modified Altemeier Technique for Stomal Prolapse: A Case Series

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