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Colostomy vs ileostomy

M F Sier, R J Oostenbroek, M G W Dijkgraaf, G J Veldink, W A Bemelman, A Pronk, E J Spillenaar-Bilgen, W Kelder, C Hoff, D T Ubbink
BACKGROUND: Morbidity in patients with an 'ostomy is high. A new care pathway, including perioperative home visits by enterostomal therapists, was studied to assess whether more elaborate education and closer guidance could reduce stoma-related complications and improve quality of life, at acceptable cost. METHODS: Patients requiring an ileostomy or colostomy, for any inflammatory or malignant bowel disease, were included in a 15-centre cluster-randomised 'stepped-wedge' study...
February 13, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Yuxiang Wen, Murad A Jabir, Michael Keating, Alison R Althans, Justin T Brady, Bradley J Champagne, Conor P Delaney, Scott R Steele
BACKGROUND: Postoperative ileus (POI) is a major cause of morbidity, increased length of stay (LOS) and hospital cost after colorectal surgery. Alvimopan is a µ-opioid antagonist used to accelerate upper and lower gastrointestinal function after bowel resection. We hypothesized that alvimopan would reduce LOS in patients undergoing colorectal resection with stoma, a situation that has not been evaluated. METHODS: A retrospective review (2010-2015) identified 58 patients who underwent colorectal resection for benign or malignant disease with stoma creation and received alvimopan...
December 7, 2016: Surgical Endoscopy
Stephen J Chapman, Benjamin Wood, Thomas M Drake, Neville Young, David G Jayne
BACKGROUND: Implantation of mesh at the time of stoma formation may reduce the rate of parastomal hernia. Until recently, the evidence has been limited to only a few small randomized controlled trials. OBJECTIVE: We present an updated systematic review and meta-analysis to assess the effect of mesh prophylaxis on rates of parastomal hernia. We examine ongoing and unpublished trials via online registries and propose recommendations for future research. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Library were searched up to March 2016 for published randomized controlled trials...
January 2017: Diseases of the Colon and Rectum
Liming Liu, Qi Huang, Jialiang Wang, Quanning Chen, Rui Lin, Bujun Ge
A temporarily defunctioning stoma, while effective at reducing symptomatic anastomotic leakage after low anterior resection (LAR) of rectal cancer, and its subsequent closure, is associated with significant morbidity. Here, we devised a new tube ileostomy using a biofragmentable anastomosis ring (TIB) with no need for reversal.This is a retrospective cohort study. From June 2011 to March 2015, TIBs were performed on 31 consecutive patients with mid- or low-rectal cancer who underwent elective laparoscopic LARs...
November 2016: Medicine (Baltimore)
Wei Jiang, Zhihui Tong, Dongliang Yang, Lu Ke, Xiao Shen, Jing Zhou, Gang Li, Weiqin Li, Jieshou Li
Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN).Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes...
April 2016: Medicine (Baltimore)
Syed Nabeel Zafar, Navin R Changoor, Kibileri Williams, Rafael D Acosta, Wendy R Greene, Terrence M Fullum, Adil H Haider, Edward E Cornwell, Daniel D Tran
BACKGROUND: Many temporary stomas are never reversed leading to significantly worse quality of life. Recent evidence suggests a lower rate of reversal among minority patients. Our study aimed to elucidate disparities in national stoma closure rates by race, medical insurance status, and household income. METHODS: Five years of data from the Nationwide Inpatient Sample (2008 to 2012) was used to identify the annual rates of stoma formation and annual rates of stoma closure...
April 2016: American Journal of Surgery
F H W Jonker, P J Tanis, P P L O Coene, L Gietelink, E van der Harst
AIM: This study used a national registry to compare the outcome after a low Hartmann's procedure (LHP), defined as removal of most of the rectum to leave a short anorectal stump and an end colostomy, and low anterior resection (LA) with or without a diverting ileostomy (DI) in rectal cancer patients all of whom had received preoperative neoadjuvant radiotherapy (RT). METHOD: Patients who underwent LHP or LA with or without DI for rectal cancer after RT between 2009 and 2013 were identified from the Dutch Surgical Colorectal Audit...
August 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jennifer Blumetti, Herand Abcarian
Anastomotic leak continues to be a dreaded complication after colorectal surgery, especially in the low colorectal or coloanal anastomosis. However, there has been no consensus on the management of the low colorectal anastomotic leak. Currently operative procedures are reserved for patients with frank purulent or feculent peritonitis and unstable vital signs, and vary from simple fecal diversion with drainage to resection of the anastomosis and closure of the rectal stump with end colostomy (Hartmann's procedure)...
December 27, 2015: World Journal of Gastrointestinal Surgery
Raymond Oliphant, Alex Czerniewski, Isabell Robertson, Clare McNulty, Ashita Waterston, Angus Macdonald
PURPOSE: To assess stoma-related complications of colorectal cancer patients undergoing surgery with curative intent who received adjuvant chemotherapy compared to those who underwent surgery alone. DESIGN: A retrospective analysis of a prospectively maintained colorectal cancer clinical audit database was completed. SUBJECTS AND SETTINGS: Patients undergoing curative surgery for colorectal cancer with the formation of a stoma (end ileostomy, loop ileostomy, end colostomy) between 1999 and 2011 at a single hospital in Lanarkshire, United Kingdom...
September 2015: Journal of Wound, Ostomy, and Continence Nursing
Zhi-Liang Lin, Wen-Kui Yu, Jia-Liang Shi, Qi-Yi Chen, Shan-Jun Tan, Ning Li
BACKGROUND/AIMS: In critically ill patients, gastrointestinal function plays an important role in multiple organ dysfunction syndrome. Patients suffering from acute lower gastrointestinal dysfunction need to be performed a temporary fecal diversion after the failure of conservative treatment. This study aims to determine which type of fecal diversion is associated with better clinical outcomes in critically ill patients. METHODOLOGY: Data of critically ill patients requiring surgical decompression following acute lower gastrointestinal dysfunction between January 2008 and June 2013 were retrospectively analyzed...
May 2014: Hepato-gastroenterology
Cigdem Benlice, Emre Gorgun, Erman Aytac, Gokhan Ozuner, Feza H Remzi
BACKGROUND: The aim of this study is to evaluate the impact of concurrent mesh herniorrhaphy on short-term outcomes of colorectal surgery by using a large, nationwide database. METHODS: Patients who underwent simultaneous ventral hernia repair (VHR) and colorectal surgery between 2005 and 2010 were identified from the American College of Surgeons National Surgical Quality Improvement Program. Patients who underwent VHR with mesh repair were case matched with patients who underwent VHR without mesh based on the type of colorectal procedure, diagnosis, and American Society of Anesthesiologists score...
October 2015: American Journal of Surgery
Yuma Wada, Norikatsu Miyoshi, Masayuki Ohue, Shingo Noura, Shiki Fujino, Keijirou Sugimura, Hirofumi Akita, Masaaki Motoori, Kunihito Gotoh, Hidenori Takahashi, Shogo Kobayashi, Takeshi Ohmori, Yoshiyuki Fujiwara, Masahiko Yano
The aim of this study was to compare the incidence of postoperative complications, including superficial incisional surgical site infection (SSI) following purse-string skin closure (PS) and conventional skin closure with a drainage tube (CD) following stoma closure. A total of 55 consecutive patients who underwent loop colostomy and loop ileostomy closures in our hospital between October, 2011 and September, 2014 were retrospectively assessed. The patients were divided into two groups, namely the PS group (26 patients) and the CD group (29 patients)...
May 2015: Molecular and Clinical Oncology
Xiaolan You, Yuanjie Wang, Xiaojun Zhao, Yanjun Lian, Ning Xu, Chuanjiang Huang
OBJECTIVE: To explore the application of protective appendicostomy after sphicter-preserving surgery for patients with low rectal carcinoma who are at high-risk of anastomotic leakage. METHODS: Clinical data of 74 low rectal cancer cases with high-risk anastomotic leakage undergoing laparoscope-assisted total mesorectal excision(TME) sphincter-preserving operation in our department from September 2013 to September 2014 were analyzed retrospectively. Patients were randomly divided into two groups: 36 patients received appendicostomy and catheter was removed 4 to 6 weeks after operation when sinus tract formation in abdominal wall was identified; 38 patients received traditional ileostomy and stoma closure was performed 3 to 6 months after operation...
June 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Andrea N Doud, Edward A Levine, Nora F Fino, John H Stewart, Perry Shen, Konstantinos I Votanopoulos
INTRODUCTION: Cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) often includes stoma creation. We evaluated the indications, morbidity, and mortality associated with stoma creation and reversal after CRS/HIPEC. METHODS: Retrospective analysis of a prospective database of 1149 CRS-HIPEC procedures was performed. Patient demographics, type of malignancy, comorbidities, Clavien-graded morbidity, mortality, indications for stoma creation, and outcomes of subsequent reversal were abstracted...
February 2016: Annals of Surgical Oncology
Evangelos Messaris, Tara M Connelly, Afif N Kulaylat, Jennifer Miller, Niraj J Gusani, Gail Ortenzi, Joyce Wong, Neil Bhayani
INTRODUCTION: A diverting stoma is often performed at the time of low anterior resection (LAR) for rectal cancer after neoadjuvant chemoradiation (nCRT) to protect the anastomosis. The aim of this study was to compare surgical outcomes in large cohorts of mid-high rectal cancer patients undergoing LAR after nCRT with and without a diverting stoma. METHODS: Patients undergoing LAR for rectal cancer (ICD-9 diagnosis code 154.1) after nCRT were identified from the American College of Surgeons National Surgical Quality Improvement Program database records from 2005 to 2012...
September 2015: Surgery
Mark H Hanna, Alessio Vinci, Alessio Pigazzi
PURPOSE: The role of fecal diversion using a loop ileostomy in patients undergoing rectal resection and anastomosis is controversial. There has been conflicting evidence on the perceived benefit vs. the morbidity of a defunctioning stoma. This is a review of the relevant surgical literature evaluating the risks, benefits, and costs of constructing a diverting ileostomy in current colorectal surgical practice. METHODS: Retrospective and prospective articles spanning the past 50 years were reviewed to identify the definition of an anastomotic leak (AL), evaluate risk factors for AL, and assess methods of evaluation of the anastomosis...
February 2015: Langenbeck's Archives of Surgery
Akio Shiomi, Masaaki Ito, Kotaro Maeda, Yusuke Kinugasa, Mitsuyoshi Ota, Hiroki Yamaue, Manabu Shiozawa, Hisanaga Horie, Yoshiaki Kuriu, Norio Saito
BACKGROUND: Routine creation of a diverting stoma (DS) in every patient who undergoes low anterior resection (LAR) remains controversial. We aimed to investigate the effect of DS on symptomatic anastomotic leakage (AL) after LAR. STUDY DESIGN: Patients with rectal cancer within 10 cm from the anal verge were eligible for this prospective, multicenter, cohort study (UMIN-CTR, number 000004017). Propensity score matching (PSM) was used to compare groups of patients with and without DS...
February 2015: Journal of the American College of Surgeons
Jorge Bizet, Chad J Cooper, Marc J Zuckerman, Alireza Torabi, Antonio Mendoza-Ladd
INTRODUCTION: Invasive Aspergillus commonly involves the lungs, but can also affect other organs such as the skin, adrenal glands, central nervous system, liver, spleen and the gastrointestinal tract. Gastrointestinal aspergillosis is rare and is most often discovered in immunocompromised patients. There is only one other case report to our knowledge that describes the diagnosis being discovered on histopathological analysis of endoscopic biopsies of necrotic ulcers. CASE PRESENTATION: A 36-year-old Hispanic woman presented with septic shock secondary to extensive Fournier gangrene that required multiple surgical debridement of the perineal and retroperitoneal area...
2014: Journal of Medical Case Reports
Janet T Lee, Thao T Marquez, Daniel Clerc, Olivier Gie, Nicolas Demartines, Robert D Madoff, David A Rothenberger, Dimitrios Christoforidis
BACKGROUND: Surgical site infection after stoma reversal is common. The optimal skin closure technique after stoma reversal has been widely debated in the literature. OBJECTIVE: We hypothesized that pursestring near-complete closure of the stoma site would lead to fewer surgical site infections compared with conventional primary closure. DESIGN: This study was a parallel prospective multicenter randomized controlled trial. SETTINGS: This study was conducted at 2 university medical centers...
November 2014: Diseases of the Colon and Rectum
A Mishra, B D Keeler, C Maxwell-Armstrong, J A Simpson, A G Acheson
AIM: The aim of this study was to evaluate the incidence of incisional hernia formation after laparoscopic and open surgery for colorectal cancer. METHOD: A retrospective analysis was conducted of 1057 colorectal cancer resection cases (289 laparoscopic, 768 open) performed in a single national laparoscopic training centre between January 2006 and December 2011. Clinical notes and serial computed tomography scans were reviewed, with any incisional hernia including those at a surgical incision, port site, stoma and stoma closure site identified and the size of the defect measured...
October 2014: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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