Temporary ileostomy for ileal pouch-anal anastomosis

Metcalf, Amanda M.; Dozois, Roger R.; Beart, Robert W.; Ka, Kelly; Wolff, Bruce G.

doi:10.1007/bf02554114

Cited by 82 publications

(43 citation statements)

References 7 publications

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“…Our leak rates were similar to the 0–7% leak rate described in the literature [5, 10, 11, 22, 27]. However, we found no significant differences in the number of leaks between technique of ileostomy closure and this is in accordance with the results described by other authors [6, 11, 22, 28].…”

Section: Discussionsupporting

confidence: 82%

A Prospective Audit of the Complications of Loop Ileostomy Construction and Takedown

et al. 2004

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Aim: A prospective review of the complications of ileostomy construction and takedown. Materials and Methods: One hundred twenty-seven consecutive patients undergoing construction of a loop ileostomy were included in a prospective nonrandomized computer database. Complications of the loop ileostomy were assessed prior to and after closure. Three closure techniques were performed [enterotomy suture (25.7%), resection and hand sewn (31.2%) or stapled anastomosis (43.1%)] and compared. Results: One hundred twenty-seven (73 male, 54 female) patients, mean age 54 years were included from 1992 to 2002. Seventy-two patients underwent anterior resection for low rectal carcinoma, 30 an ileoanal pouch for ulcerative colitis and 25 for miscellaneous conditions. Fifty-nine pre-takedown complications occurred in 50 (39.4%) patients. The most common were dermatitis (12.6%) and erythema (7.1%). The most severe were dehydration in 1 patient and stomal prolapse in 4 patients. Closure was associated with a complication rate of 33.1% and a mortality rate of 0.9%. Wound infection occurred in 18.3% and small bowel obstruction in 4.6%. Anastomotic leak requiring reanastomosis occurred in 2.8% and enterocutaneous fistula treated conservatively in 5.5%. There were no statistically significant differences in morbidity between closure techniques (p = 0.892). There were no statistically significant differences in complications (p = 0.516) between patients with ulcerative colitis and those with neoplasia (39.29% vs. 32.2%). Conclusions: Loop ileostomy construction and takedown is associated with considerable morbidity, mostly minor. No differences exist between technique used for closure or the baseline pathology of the patient.

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Section: Discussionsupporting

confidence: 82%

A Prospective Audit of the Complications of Loop Ileostomy Construction and Takedown

et al. 2004

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“…Of these retraction is more worrisome as it results in skin excoriation and incomplete de-functioning of the distal anastomosis. This problem is reported to occur in up to 15.9% of patients [21]. In our study only one patient developed retraction of loop ileostomy which required reoperation.…”

Section: Discussionmentioning

confidence: 41%

A Comparative Study between Santulli Ileostomy and Loop Ileostomy

Kumar¹,

Sathyanarayana²

2016

IOSR

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“…We agree with these points, but the lack of statistical significance does not allow us to conclude anything regarding the superiority of one fecal diversion method over the other. The presence of a loop ileostomy may increase the chances of twisting the small bowel and forming adhesions adjacent to the stoma, which may induce postoperative intestinal obstruction 24 . This review did not find any significant difference in the incidence of intestinal obstruction between patients with loop ileostomy and with loop colostomy.…”

Section: -Outcome Measurements Relating To Stoma Closurementioning

confidence: 99%

“…This review did not find any significant difference in the incidence of intestinal obstruction between patients with loop ileostomy and with loop colostomy. However, several trials have reported that loop ileostomy is highly associated with this postoperative complication 14,[24][25][26][27][28] . Concerning postoperative bowel obstruction, there is some evidences that, with longer follow-up, adhesion-related complications might become more frequent, particularly after loop ileostomy closure 13 .…”

Section: -Outcome Measurements Relating To Stoma Closurementioning

confidence: 99%

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

et al. 2008

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Purpose:The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. Methods: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. Results: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I 2 = 0% for the heterogeneity test. Conclusions: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials. Key words: Ileostomy. Colostomy. Colorectal surgery. Systematic review. Meta-analysis. RESUMO Objetivo:A controvérsia entre ileostomia em alça ou colostomia em alça como a melhor forma para a descompressão temporária da anastomose colorretal motivou a realização desta revisão. Métodos: Cinco ensaios clínicos casualizados foram incluídos com 334 pacientes: 168 no grupo de ileostomia e 166 no grupo de colostomia. Os resultados analisaram: 1. Mortalidade; 2. Infecção da ferida; 3. Tempo de formação do estoma; 4. Tempo de fechamento do estoma; 5. Intervalo de tempo entre a formação e o fechamento do estoma; 6. Prolapso do estoma; 7. Retração do estoma; 8. Hérnia parastomal; 9. Fistula parastomal; 10. Estenose; 11. Necrose; 12. Irritação de pele; 13. Íleo; 14. Fístula entérica; 15. Reoperação; 16. Adaptação do paciente; 17. Tempo de internação hospitalar; 18. Deiscência da anastomose colorretal; 19. Hérnia de Incisional; 20. Obstrução intestinal pós-operatória. Resultados: Prolapso do estoma: p = 0.00001, mas com heterogeneidade estatística; a análise de sensibilidade foi aplicada excluindo os estudos que incluíram cirurgias de emergência: p = 0.02 e teste de heterogeneidade: I 2 =0%. Conclusões: Os resultados encontrados não foram estatística ou clinicamente significantes, exceto prolapso do estoma. A melhor evidência para a escolha entre ileostomia em alça ou colostomia em alça necessita de maior número de ensaios clínicos.

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Temporary ileostomy for ileal pouch-anal anastomosis

Cited by 82 publications

References 7 publications

A Prospective Audit of the Complications of Loop Ileostomy Construction and Takedown

A Prospective Audit of the Complications of Loop Ileostomy Construction and Takedown

A Comparative Study between Santulli Ileostomy and Loop Ileostomy

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

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