Annals of Coloproctology

Original Articles

ERAS

Clinical impact of a multimodal pain management protocol for loop ileostomy reversal: Jeong Sub Kim, Chul Seung Lee, Jung Hoon Bae, Seung Rim Han, Do Sang Lee, In Kyu Lee, Yoon Suk Lee, In Kyeong Kim; Ann Coloproctol. 2024;40(3):210-216. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2022.01137.0162

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Purpose
As introduced, multimodal pain management bundle for ileostomy reversal may be considered to reduce postoperative pain and hospital stay. The aim of this study was to evaluate clinical efficacy of perioperative multimodal pain bundle for ileostomy.
Methods
Medical records of patients who underwent ileostomy reversal after rectal cancer surgery from April 2017 to March 2020 were analyzed. Sixty-seven patients received multimodal pain bundle protocol with ileostomy reversal (group A) and 41 patients underwent closure of ileostomy with conventional pain management (group B).
Results
Baseline characteristics, including age, sex, body mass index, American Society of Anesthesiologists classification, diabetes mellitus, and smoking history, were not significantly different between the groups. The pain score on postoperative day 1 was significant lower in group A (visual analog scale, 2.6 ± 1.3 vs. 3.2 ± 1.2; P = 0.013). Overall consumption of opioid in group A was significant less than group B (9.7 ± 9.5 vs. 21.2 ± 8.8, P < 0.001). Hospital stay was significantly shorter in group A (2.3 ± 1.5 days vs. 4.1 ± 1.5 days, P < 0.001). There were no significant differences between the groups in postoperative complication rate.
Conclusion
Multimodal pain protocol for ileostomy reversal could reduce postoperative pain, usage of opioid and hospital stay compared to conventional pain management.

Citations

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Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Multimodal analgesia for postoperative pain: pursuing liberation from pain, not redemption
Soo Yeun Park
Annals of Coloproctology.2024; 40(3): 189. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Optimizing postoperative pain management in minimally invasive colorectal surgery
Soo Young Lee
Annals of Coloproctology.2024; 40(6): 525. CrossRef

Benign bowel disease

Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review: Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee; Ann Coloproctol. 2024;40(5):424-430. Published online March 2, 2023; DOI: https://doi.org/10.3393/ac.2022.00976.0139

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Abstract PDF Supplementary Material: Purpose
Ileostomy volvulus is a rare cause of small bowel obstruction. We present an unusual case of ileostomy volvulus without the presence of adhesions. Additionally, a systematic literature review was performed to collate the current literature on the causes, diagnosis, treatment, and preventative measures of ileostomy-related small bowel obstruction.
Methods
PubMed (MEDLINE), Embase, Google Scholar, Scopus, and CENTRAL were searched from their inception up to August 2022. This study adhered to the PRISMA guidelines and was registered on PROSPERO. The primary outcomes included patients’ demographics, imaging modality, indication for initial surgery, type and configuration of stoma, surgical treatment, and recurrence of volvulus. The quality of included studies was assessed using the Murad tool. Written informed consent was obtained from the patient.
Results
Seven studies were included, comprising 967 patients. Stoma outlet obstruction (SOO) was reported in all 159 patients, and 12 had ileostomy volvulus as the cause. A majority of patients had loop ostomies for ileostomy volvulus. No complications or mortality were reported in the included studies, and half of the included studies were deemed to be of good quality.
Conclusion
This case demonstrates the need for high clinical suspicion of SOO in patients with loop ileostomy, and rapid management should be undertaken. Whilst loop ileostomies, increased rectus abdominal muscle thickness, and lower preoperative total glucocorticoid dosage are associated with SOO, large-scale retrospective studies are needed to validate our findings.

Stoma

Protective loop ileostomy or colostomy? A risk evaluation of all common complications: Yi-Wen Yang, Sheng-Chieh Huang, Hou-Hsuan Cheng, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Chun-Chi Lin, Hung-Hsin Lin, Yuan-Tzu Lan; Ann Coloproctol. 2024;40(6):580-587. Published online January 27, 2023; DOI: https://doi.org/10.3393/ac.2022.00710.0101

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Abstract PDF

Purpose
Protective ileostomy and colostomy are performed in patients undergoing low anterior resection with a high leakage risk. We aimed to compare surgical, medical, and daily care complications between these 2 ostomies in order to make individual choice.
Methods
Patients who underwent low anterior resection for rectal tumors with protective stomas between January 2011 and September 2018 were enrolled. Stoma-related complications were prospectively recorded by wound, ostomy, and continence nurses. The cancer stage and treatment data were obtained from the Taiwan Cancer Database of our Big Data Center. Other demographic data were collected retrospectively from medical notes. The complications after stoma creation and after the stoma reversal were compared.
Results
There were 176 patients with protective colostomy and 234 with protective ileostomy. Protective ileostomy had higher proportions of high output from the stoma for 2 consecutive days than protective colostomy (11.1% vs. 0%, P<0.001). Protective colostomy resulted in more stoma retraction than protective ileostomy (21.6% vs. 9.4%, P=0.001). Female, open operation, ileostomy, and carrying stoma more than 4 months were also significantly associated with a higher risk of stoma-related complications during diversion. For stoma retraction, the multivariate analysis revealed that female (odds ratio [OR], 4.00; 95% confidence interval [CI], 2.13–7.69; P<0.001) and long diversion duration (≥4 months; OR, 2.33; 95% CI, 1.22–4.43; P=0.010) were independent risk factors, but ileostomy was an independent favorable factor (OR, 0.40; 95% CI, 0.22–0.72; P=0.003). The incidence of complication after stoma reversal did not differ between colostomy group and ileostomy group (24.3% vs. 20.9%, P=0.542).
Conclusion
We suggest avoiding colostomy in patients who are female and potential prolonged diversion when stoma retraction is a concern. Otherwise, ileostomy should be avoided for patients with impaired renal function. Wise selection and flexibility are more important than using one type of stoma routinely.

Citations

Citations to this article as recorded by

Gut microbiome and plasma metabolome alterations in ileostomy and after closure of ileostomy
Liang Xu, Xiaolong Li, Lang Chen, Haitao Ma, Ying Wang, Wenwen Liu, Anyan Liao, Liang Tan, Xiao Gao, Weidong Xiao, Hua Yang, Guangyan Ji, Yuan Qiu, Wei-Hua Chen, Qin Liu, Song Liu, Yang Yang
Microbiology Spectrum.2025;[Epub] CrossRef
Effect of one-stitch method of temporary ileostomy on the surgical outcomes and complications after laparoscopic low anterior resection in rectal cancer patients: a propensity score matching analysis
Xin-Peng Shu, Jia-Liang Wang, Zi-Wei Li, Fei Liu, Xu-Rui Liu, Lian-Shuo Li, Yue Tong, Xiao-Yu Liu, Chun-Yi Wang, Yong Cheng, Dong Peng
European Journal of Medical Research.2025;[Epub] CrossRef
The Differences in Postoperative Nursing Between Temporary Ileostomy and Temporary Colostomy: A Retrospective Cohort Study
Mei Wang, Lihong Dai, Xia Fang, Yan Zheng, Yuanhao Shen, Yang Yu
Nursing Open.2025;[Epub] CrossRef
Uso de ileostomía derivativa en cáncer de ovario. Revisión de la literatura
Franco Rafael Ruiz-Echeverría, Pedro Hernando Calderón-Quiroz, Juliana Rendón-Hernández
Revista Colombiana de Cirugía.2024;[Epub] CrossRef
Meta-analysis: loop ileostomy versus colostomy to prevent complications of anterior resection for rectal cancer
Shilai Yang, Gang Tang, Yudi Zhang, Zhengqiang Wei, Donglin Du
International Journal of Colorectal Disease.2024;[Epub] CrossRef
The Role of Colon in Isolated Intestinal Transplantation: Description of 4 Cases
Pierpaolo Di Cocco, Giulia Bencini, Alessandro Martinino, Egor Petrochenkov, Stepan Akshelyan, Kentaro Yoshikawa, Mario Spaggiari, Jorge Almario-Alvarez, Ivo Tzvetanov, Enrico Benedetti, Gaetano Gallo
International Journal of Surgical Oncology.2024;[Epub] CrossRef

Benign bowel disease

Short-term outcomes in patients undergoing laparoscopic surgery for deep infiltrative endometriosis with rectal involvement: a single-center experience of 168 cases: Sara Gortázar de las Casas, Emanuela Spagnolo, Salomone Di Saverio, Mario Álvarez-Gallego, Ana López Carrasco, María Carbonell López, Sergio Torres Cobos, Constantino Fondevila Campo, Alicia Hernández Gutiérrez, Isabel Pascual Miguelañez; Ann Coloproctol. 2023;39(3):216-222. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00829.0118

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Abstract PDF

Purpose
The surgical management of deep infiltrative endometriosis (DE) involving the rectum remains a challenge. The objective of this study was to assess the outcomes from a single tertiary center over a decade with an emphasis on the role of a protective loop ileostomy (PI).
Methods
A retrospective review of outcomes for 168 patients managed between 2008 and 2018 is presented including 57 rectal shaves, 23 discoid excisions, and 88 segmental rectal resections.
Results
The nodule size (mean±standard deviation) in the segmental resection group was 32.7±11.2 mm, 23.4±10.5 mm for discoid excision, and 18.8±6.0 mm for rectal shaves. A PI was performed in 19 elective cases (11.3%) usually for an ultra-low anastomosis <5 cm from the anal verge. All Clavien-Dindo grade III/IV complications occurred after segmental resections and included 5 anastomotic leaks, 6 rectovaginal fistulas, 2 ureteric fistulas, and 1 ureteric stenosis. Of 26 stomas (15.5%), there were 19 PIs, 3 secondary ileostomies (after complications), and 4 end colostomies. The median time to PI closure was 5.8 months (range, 0.4–16.7 months) in uncomplicated disease compared with 9.2 months (range, 4.7–18.4 months) when initial postoperative complications were recorded (P=0.019). Only 1 patient with a recurrent rectovaginal fistula had a permanent colostomy.
Conclusion
In patients with DE and rectal involvement a PI is selectively used for low anastomoses and complex pelvic reconstructions. Protective stomas and those used in the definitive management of a major postoperative complication can usually be reversed.

Citations

Citations to this article as recorded by

Surgeons' workload assessment during indocyanine-assisted deep endometriosis surgery using the surgery task load index: The impact of the learning curve
Emanuela Spagnolo, Ignacio Cristóbal Quevedo, Sara Gortázar de las Casas, Ana López Carrasco, Maria Carbonell López, Isabel Pascual Migueláñez, Alicia Hernández Gutiérrez
Frontiers in Surgery.2022;[Epub] CrossRef
Quality of Life in Women after Deep Endometriosis Surgery: Comparison with Spanish Standardized Values
Alicia Hernández, Elena Muñoz, David Ramiro-Cortijo, Emanuela Spagnolo, Ana Lopez, Angela Sanz, Cristina Redondo, Patricia Salas, Ignacio Cristobal
Journal of Clinical Medicine.2022; 11(20): 6192. CrossRef

Benign proctology,Rare disease & stoma,Surgical technique

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction: Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

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Graphical Abstract Abstract PDF

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries: Dan Assaf, David Hazzan, Almog Ben-Yaacov, Shachar Laks, Douglas Zippel, Lior Segev; Ann Coloproctol. 2023;39(2):168-174. Published online August 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00241.0034

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Abstract PDF

Purpose
One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS.
Methods
We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group.
Results
A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001).
Conclusion
Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.

Citations

Citations to this article as recorded by

High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
A review of chyme reinfusion: new tech solutions for age old problems
Chen Liu, Sameer Bhat, Ian Bissett, Gregory O'Grady
Journal of the Royal Society of New Zealand.2024; 54(2): 161. CrossRef
Knowledge, attitudes, practices and associated factors regarding high output stoma of ileostomy among colorectal surgical nurses: a multicentre cross-sectional study
Qing Zhang, Jianan Sun, Dongxue Wang, Quan Wang, Haiyan Hu
Supportive Care in Cancer.2024;[Epub] CrossRef
Morphological predictors of water-electrolyte disorders in patients with preventive ileostomy after rectal resection for cancer
A.I. Maksimkin, Z.A. Bagatelia, V.M. Kulushev, E.N. Gordienko, M.S. Lebedko, S.S. Anikina, E.P. Shin
Pirogov Russian Journal of Surgery.2024; (4): 16. CrossRef
The Frequency of Stoma-Related Readmissions After Emergency and Elective Ileostomy Formation: The Leicester Experience
Ting-Wei Wu, Wen Yuan Chung, Hui En Jewel Ng, Ashley Yap, Konstantinos Baronos, Deepak Paul, Christopher P Neal, David Bowrey
Cureus.2024;[Epub] CrossRef
Predictors of High-output Stoma in Diverting Ileostomy for Rectal Cancer Surgery
Hiroaki Uehara, Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Yuya Enoki
Nippon Daicho Komonbyo Gakkai Zasshi.2023; 76(3): 286. CrossRef
Morpho-functional aspects of various parts of the intestine and risk factors associated with the preventive ileostomy (review)
A. I. Maksimkin, Z. A. Bagatelia, E. N. Gordienko, E. B. Emelyanova, D. M. Sakaeva
Koloproktologia.2023; 22(4): 147. CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Benign GI diease,Benign diesease & IBD,Rare disease & stoma

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons: David A. Clark, Bree Stephensen, Aleksandra Edmundson, Daniel Steffens, Michael Solomon; Ann Coloproctol. 2021;37(5):337-345. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.14.1

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Abstract PDF

Purpose
Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.
Methods
A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons on September 20, 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in 12 months, along with the surgeon’s preference for the use of diverting stomas, rectal tubes, and pelvic drains.
Results
There were 90 respondents to the survey (31.6%). Surgeons in Western Australia (71.4%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14.3%). South Australian surgeons are more likely to employ a mandatory TDI (100%) for ileal pouches than Queensland surgeons (42.9%). Rectal tubes are not commonly utilized (40.0% never use them), and pelvic drains are (45.6% in all cases). Surgeons consider a median AL rate of 15% was felt to justify the use of a TDI in low pelvic anastomoses and a median AL rate of 10% for ileal pouches
Conclusion
There is considerable geographical variation in colorectal surgical practice throughout Australia and New Zealand. While surgeons interrogate the same literature, there are presumably other factors that see translation into variations in clinical practice.

Citations

Citations to this article as recorded by

Predictors of pouch failure and quality of life following ileal pouch‐anal anastomosis for ulcerative colitis: a retrospective multicenter study
Ahmet Rencuzogullari, Cihangir Akyol, Ismail Hamzaoglu, Tahsin Colak, Tayfun Karahasanoglu, Ugur Sungurtekin, Sezai Leventoglu, Ersin Ozturk, Mustafa Ali Korkut, Selman Sokmen
ANZ Journal of Surgery.2025; 95(3): 457. CrossRef
Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study
David A. Clark, Karen Dobeli, Darren Allen, Brett McWhinney, Michael Lonne, Aleksandra Edmundson
Colorectal Disease.2025;[Epub] CrossRef
Feasibility of triple assessment of the anastomosis using an anastomotic checklist
Madeleine Louise Kelly, Amy Cao, Ruben Rajan, David A Clark
ANZ Journal of Surgery.2024; 94(10): 1812. CrossRef
Drain fluid amylase as a biomarker for the detection of anastomotic leakage after rectal resection without a diverting ileostomy
David A. Clark, Aleksandra Edmundson, Daniel Steffens, Craig Harris, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 813. CrossRef
Surgical management and long‐term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy
Tony McGiffin, David A. Clark, Aleks Edmundson, Daniel Steffens, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 806. CrossRef
Does an ileostomy cover the surgeon or the anastomosis?
David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
ANZ Journal of Surgery.2022; 92(1-2): 19. CrossRef
Risk taking propensity: Nurse, surgeon and patient preferences for diverting ileostomy
Ian Mackay, David A. Clark, James Nicholson, Aleks Edmundson, Daniel Steffens, Michael Solomon
Colorectal Disease.2022; 24(9): 1073. CrossRef
Multicenter Study of Drain Fluid Amylase as a Biomarker for the Detection of Anastomotic Leakage After Ileal Pouch Surgery Without a Diverting Ileostomy
David A. Clark, • Aleksandra Edmundson, Daniel Steffens, Graham Radford-Smith, Michael Solomon
Diseases of the Colon & Rectum.2022; 65(11): 1335. CrossRef
An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: Not yet ready to translate research studies into clinical practice
David A. Clark, Daniel Steffens, Michael Solomon
Colorectal Disease.2021; 23(11): 2795. CrossRef

Malignant disease, Functional outcomes,Colorectal cancer

The Relationship Between High-Output Stomas, Postoperative Ileus, and Readmission After Rectal Cancer Surgery With Diverting Ileostomy: Naa Lee, Soo Young Lee, Chang Hyun Kim, Han Deok Kwak, Jae Kyun Ju, Hyeong Rok Kim; Ann Coloproctol. 2021;37(1):44-50. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.03

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Abstract PDF

Purpose
This study aimed to evaluate the relationship between high-output stomas (HOSs), postoperative ileus (POI), and readmission after rectal cancer surgery with diverting ileostomy.
Methods
We included 302 patients with rectal cancer who underwent restorative resection with diverting ileostomy between January 2011 and December 2015. HOSs were defined as stomas with ≥ 2,000 mL/day output. We analyzed predictive factors for readmission of these patients.
Results
Forty-eight patients (15.9%) had HOSs during the hospital stay, and 41 patients (13.6%) experienced POI. HOSs were strongly associated with POI (45.8% vs. 7.5%, P < 0.001). The all-cause readmission rate was 16.9%, with 19 (6.3%) and 20 (6.6%) experiencing ileus and acute kidney injury, respectively. HOSs (27.1% vs. 15.0%, P = 0.040) and POI (34.1% vs. 14.2%, P = 0.002) were associated with all-cause readmission, and POI was associated with readmission with ileus (17.1% vs. 4.6%, P = 0.007). POI was an independent risk factor for all-cause readmission (adjusted odds ratio [OR], 2.640; 95% confidence interval [CI], 1.162 to 6.001; P = 0.020) and readmission with ileus (adjusted OR = 3.869; 95% CI 1.387 to 10.792; P = 0.010).
Conclusion
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.

Citations

Citations to this article as recorded by

High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
Summary of Best Evidence for the Dietary Management in Patients with High-Output Ileostomy
Ying Wang, Hua Peng, Cui Cui, Qi Zou, Mudi Yang
Journal of Multidisciplinary Healthcare.2025; Volume 18: 877. CrossRef
Maximizing Readmission Reduction in Colon Cancer Patients
Mario Schootman, Chenghui Li, Jun Ying, Sonia T. Orcutt, Jonathan Laryea
Journal of Surgical Research.2024; 295: 587. CrossRef
Analysis of decision-making factors for defunctioning ileostomy after rectal cancer surgery and their impact on perioperative recovery: a retrospective study of 1082 patients
Xiaojiang Yi, Huaguo Yang, Hongming Li, Xiaochuang Feng, Weilin Liao, Jiaxin Lin, Zhifeng Chen, Dechang Diao, Manzhao Ouyang
Surgical Endoscopy.2024; 38(11): 6782. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis
I. Vogel, M. Shinkwin, S. L. van der Storm, J. Torkington, J. A.Cornish, P. J. Tanis, R. Hompes, W. A. Bemelman
Techniques in Coloproctology.2022; 26(5): 333. CrossRef
Postoperative paralytic ileus following debulking surgery in ovarian cancer patients
Eva K. Egger, Freya Merker, Damian J. Ralser, Milka Marinova, Tim O. Vilz, Hanno Matthaei, Tobias Hilbert, Alexander Mustea
Frontiers in Surgery.2022;[Epub] CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Case Report

Benign GI diease,Benign diesease & IBD,Complication

Clostridium difficile Infection After Ileostomy Reversal: Ho Seung Kim, Jae Hyun Kang, Han-gil Kim, Young Hun Kim, Hyeonwoo Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S4-S6. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.24

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Abstract PDF

Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.

Citations

Citations to this article as recorded by

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Malignant disease, Functional outcomes

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings: Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2020;36(1):17-21. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.25

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Abstract PDF

Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

Citations

Citations to this article as recorded by

Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Journal of Minimally Invasive Surgery.2025; 28(1): 47. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef

Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery: Yoo Jin Choi, Jung-Myun Kwak, Neul Ha, Tae Hoon Lee, Se Jin Baek, Jin Kim, Seon Hahn Kim; Ann Coloproctol. 2019;35(4):187-193. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.1

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Abstract PDF

Purpose
No guidelines exist detailing when to implement a temporary ileostomy closure in the setting of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer. The aim of this study was to evaluate the clinical and oncological outcomes of ileostomy closure during adjuvant chemotherapy in patients with curative resection of rectal cancer.
Methods
This retrospective study investigated 220 patients with rectal cancer undergoing sphincter-saving surgery with protective loop ileostomy from January 2007 to August 2016. Patients were divided into 2 groups: group 1 (n = 161) who underwent stoma closure during adjuvant chemotherapy and group 2 (n = 59) who underwent stoma closure after adjuvant chemotherapy.
Results
No significant differences were observed in operative time, blood loss, postoperative hospital stay, or postoperative complications in ileostomy closure between the 2 groups. No difference in overall survival (P = 0.959) or disease-free survival (P = 0.114) was observed between the 2 groups.
Conclusion
Ileostomy closure during adjuvant chemotherapy was clinically safe, and interruption of chemotherapy due to ileostomy closure did not change oncologic outcomes.

Citations

Citations to this article as recorded by

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer
Fan He, Fuyu Yang, Chenglin Tang, Defei Chen, Dongqin Zhao, Junjie Xiong, Yu Zou, Guoquan Huang, Kun Qian, Masanao Nakamura
Canadian Journal of Gastroenterology and Hepatology.2024; 2024: 1. CrossRef
Prophylactic effect of retromuscular mesh placement during loop ileostomy closure on incisional hernia incidence—a multicentre randomised patient- and observer-blind trial (P.E.L.I.O.N trial)
Sven Müller, Dirk Weyhe, Florian Herrle, Philipp Horvath, Robert Bachmann, Viktor von Ehrlich-Treuenstätt, Patrick Heger, Nadir Nasir, Christina Klose, Alexander Ritz, Anja Sander, Erich Grohmann, Colette Dörr-Harim, André L. Mihaljevic
Trials.2023;[Epub] CrossRef
Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre
H.-H. Cheng, Y.-C. Shao, C.-Y. Lin, T.-W. Chiang, M.-C. Chen, T.-Y. Chiu, Y.-L. Huang, C.-C. Chen, C.-P. Chen, F.-F. Chiang
Techniques in Coloproctology.2023; 27(12): 1227. CrossRef
Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients
Kun-Yu Tsai, Jeng-Fu You, Shu-Huan Huang, Tzong-yun Tsai, Pao-Shiu Hsieh, Cheng-Chou Lai, Wen-Sy Tsai, Hsin-Yuan Hung
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Early versus late closure of temporary ileostomy after rectal cancer surgery: a meta-analysis
Li Wang, Xinling Chen, Chen Liao, Qian Wu, Hongliang Luo, Fengming Yi, Yiping Wei, Wenxiong Zhang
Surgery Today.2021; 51(4): 463. CrossRef
Low albumin level and longer interval to closure increase the early complications after ileostomy closure
HyungJoo Baik, Ki Beom Bae
Asian Journal of Surgery.2021; 44(1): 352. CrossRef
Does the timing of protective ileostomy closure post-low anterior resection have an impact on the outcome? A retrospective study
Fozan Sauri, Ahmad Sakr, Ho Seung Kim, Mohammed Alessa, Radwan Torky, Eman Zakarneh, Seung Yoon Yang, Nam Kyu Kim
Asian Journal of Surgery.2021; 44(1): 374. CrossRef
Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis
I. Vogel, N. Reeves, P. J. Tanis, W. A. Bemelman, J. Torkington, R. Hompes, J. A. Cornish
Techniques in Coloproctology.2021; 25(7): 751. CrossRef
Clinical Outcomes of Ileostomy Closure before Adjuvant Chemotherapy after Rectal Cancer Surgery: An Observational Study from a Chinese Center
Zhen Sun, Yufeng Zhao, Lu Liu, Jichao Qin, Zhongguang Luo
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Delayed ileostomy closure increases the odds of Clostridium difficile infection
Simon J. G. Richards, Dilshan K. Udayasiri, Ian T. Jones, Ian A. Hastie, Raaj Chandra, Jacob J. McCormick, Timothy J. Chittleborough, David J. Read, Ian P. Hayes
Colorectal Disease.2021; 23(12): 3213. CrossRef
The effect of ileostomy closure timing on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer
Hemn Hussain Kaka Ali, Qalandar Hussein Abdulkarim, Karzan Seerwan, Barham M. M .Salih, Omar H Ghalib Hawramy, Dara Ahmed Mohammed, Syamand Orhaman Ahmed
Kurdistan Journal of Applied Research.2021; : 126. CrossRef
Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients
Marcin Zeman, Marek Czarnecki, Andrzej Chmielarz, Adam Idasiak, Maciej Grajek, Agnieszka Czarniecka
World Journal of Surgical Oncology.2020;[Epub] CrossRef

Anastomotic Sinus That Developed From Leakage After a Rectal Cancer Resection: Should We Wait for Closure of the Stoma Until the Complete Resolution of the Sinus?: Chris Tae-Young Chung, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2019;35(1):30-35. Published online January 25, 2019; DOI: https://doi.org/10.3393/ac.2018.08.13

6,189 View
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Abstract PDF

Purpose
The aims of this study were to identify the clinical characteristics of an anastomotic sinus and to assess the validity of delaying stoma closure in patients until the complete resolution of an anastomotic sinus.
Methods
The subject patients are those who had undergone a resection of rectal cancer from 2011 to 2017, who had a diversion ileostomy protectively or therapeutically and who developed a sinus as a sequelae of anastomotic leakage. The primary outcomes that were measured were the incidence, management and outcomes of an anastomotic sinus.
Results
Of the 876 patients who had undergone a low anterior resection, 14 (1.6%) were found to have had an anastomotic sinus on sigmoidoscopy or a gastrografin enema before their ileostomy closure. In the 14 patients with a sinus, 7 underwent ileostomy closure as scheduled, with a mean closure time of 4.1 months. The remaining 7 patients underwent ileostomy repair, but it was delayed until after the follow-up for the widening of the sinus opening by using digital dilation, with a mean closure time of 6.9 months. Four of those remaining seven patients underwent stoma closure even though their sinus condition had not yet been completely resolved. No pelvic septic complications occurred after closure in any of the 14 patients with an anastomotic sinus, but 2 of the 14 needed a rediversion due to a severe anastomotic stricture.
Conclusion
Patients with an anastomotic sinus who had been carefully selected underwent successful ileostomy closure without delay.

Citations

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Management of Low-Rectal Anastomotic Sinus With Transanal Minimally Invasive Septotomy
Nirvana B. Saraswat, Scott A. Brill, William E. Wise
The American Surgeon™.2023; 89(2): 322. CrossRef
The management of asymptomatic radiological anastomotic leakage following anterior resection
Mohamed Rabie, Laura Parry, Iannish Sadien, Sandeep Kapur, Adam Stearns, Irshad Shaikh
ANZ Journal of Surgery.2022; 92(4): 801. CrossRef
Chronische Anastomoseninsuffizienz nach tiefer Rektumresektion – ein ungelöstes Problem?
Peter Kienle, Jörn Richard Magdeburg
Der Chirurg.2021; 92(7): 605. CrossRef
Response to Dioscoridi et al.
G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. T. Kjossev, M. S. Tabakov
Colorectal Disease.2020; 22(7): 841. CrossRef
Anastomotic Sinus Developed From Leakage in Rectal Cancer Resection: When Can We Reverse the Defunctioning Stoma?
Chang Hyun Kim
Annals of Coloproctology.2019; 35(1): 1. CrossRef

Postoperative Outcomes of Stoma Takedown: Results of Long-term Follow-up: Bomina Paik, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee; Ann Coloproctol. 2018;34(5):266-270. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2017.12.13

5,537 View
164 Download
6 Web of Science
8 Citations

Abstract PDF

Purpose
Stoma takedown is a frequently performed procedure with considerable postoperative morbidities. Various skin closure techniques have been introduced to reduce surgical site infections. The aim of this study was to assess postoperative outcomes after stoma takedown during a long-term follow-up period.
Methods
Between October 2006 and December 2015, 84 consecutive patients underwent a colostomy or ileostomy takedown at our institution. Baseline characteristics and perioperative outcomes were analyzed through retrospective reviews of medical records.
Results
The proportion of male patients was 60.7%, and the mean age of the patients was 59.0 years. The overall complication rate was 28.6%, with the most common complication being prolonged ileus, followed by incisional hernia, anastomotic leakage, surgical site infection, anastomotic stenosis, and entero-cutaneous fistula. The mean follow-up period was 64.3 months. The univariate analysis revealed no risk factors related to overall complications or prolonged ileus.
Conclusion
The postoperative clinical course and long-term outcomes following stoma takedown were acceptable. Stoma takedown is a procedure that can be performed safely.

Citations

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Complicated diverticulitis: Diagnostic precision and surgical solutions in a patient with chronic kidney disease
Sharon L. Hsieh, Nathaniel Grabill, Mena Louis, Bradley Kuhn
Radiology Case Reports.2025; 20(1): 346. CrossRef
Comparing Surgical Site Infection Rate Between Primary Closure and Rhomboid Flap After Stoma Reversal
Che-Ming Chu, Chih-Cheng Chen, Yu-Yao Chang, Kai-Jyun Syu, Shih-Lung Lin
Annals of Plastic Surgery.2024; 92(1S): S33. CrossRef
TIMING OF THE STOMA REVERSAL, WHAT IS THE SAFE PERIOD?: A RETROSPECTIVE OBSERVATIONAL STUDY
GIRIDHAR ASHWATH, ESHWAR KATHIRESAN MANASIJAN, ANTHONY P ROZARIO
Asian Journal of Pharmaceutical and Clinical Research.2024; : 181. CrossRef
Diverting ileostomy in benign colorectal surgery: the real clinical cost analysis
F. Ascari, G. Barugola, G. Ruffo
Updates in Surgery.2024; 76(5): 1761. CrossRef
Laparoscopic versus open Hartmann reversal: a propensity score matching analysis
Li Tan, Xiao-Yu Liu, Bin Zhang, Lian-Lian Wang, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Defunctioning stoma in anterior resection for rectal cancer does not impact anastomotic leakage: a national population-based cohort study
Eihab Munshi, Marie-Louise Lydrup, Pamela Buchwald
BMC Surgery.2023;[Epub] CrossRef
Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure
Muhammad Awais Khan, Khurram Niaz, Shahzeb Asghar, Maaz A Yusufi, Mohtamam Nazir, Syed Muhammad Ali, Aryan Ahmed, Akeel Ahamed Salahudeen, Talha Kareem
Cureus.2023;[Epub] CrossRef
Factors Predicting the Reversal of Hartmann’s Procedure
Ömer Yalkın, Fatih Altıntoprak, Mustafa Yener Uzunoğlu, Yasin Alper Yıldız, Muhammet Burak Kamburoğlu, Necattin Fırat, Fehmi Çelebi, Mihajlo Jakovljevic
BioMed Research International.2022;[Epub] CrossRef

Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-ichi Kosugi, Toshifumi Wakai; Ann Coloproctol. 2018;34(2):94-100. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14

8,042 View
114 Download
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10 Citations

Abstract PDF

Purpose
Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC.
Methods
The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters.
Results
The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO.
Conclusion
The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

Citations

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Management of J-pouch Complications
Beatrix H. Choi, David Cohen, Caleah Kitchens, David M. Schwartzberg
Surgical Clinics of North America.2025; 105(2): 357. CrossRef
Influence of the rotation of the diverting loop ileostomy in rectal cancer surgery on small-bowel obstruction: A multicenter prospective study conducted by the Clinical Study Group of Osaka University, Colorectal Group
Masaaki Miyo, Mamoru Uemura, Yuki Ozato, Junichi Nishimura, Ken Nakata, Yozo Suzuki, Yoshinori Kagawa, Taishi Hata, Koji Munakata, Mitsuyoshi Tei, Genta Sawada, Shinichi Yoshioka, Yusuke Takahashi, Koji Oba, Tsuyoshi Hata, Takayuki Ogino, Norikatsu Miyosh
Surgery.2025; 178: 108874. CrossRef
Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis
Keisuke Ihara, Takatoshi Nakamura, Masashi Takayanagi, Junki Fujita, Yasunori Maeda, Yusuke Nishi, Norisuke Shibuya, Hiroyuki Hachiya, Mitsuru Ishizuka, Keiichi Tominaga, Kazuyuki Kojima, Atsushi Irisawa
Journal of the Anus, Rectum and Colon.2024; 8(1): 18. CrossRef
Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review
Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee
Annals of Coloproctology.2024; 40(5): 424. CrossRef
Association Between Advanced T Stage and Thick Rectus Abdominis Muscle and Outlet Obstruction and High-Output Stoma After Ileostomy in Patients With Rectal Cancer
Yasuhiro Komatsu, Kunitoshi Shigeyasu, Sho Takeda, Yoshiko Mori, Kazutaka Takahashi, Nanako Hata, Kokichi Miyamoto, Hibiki Umeda, Yoshihiko Kakiuchi, Satoru Kikuchi, Shuya Yano, Shinji Kuroda, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Masahi
International Surgery.2022; 106(3): 102. CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef
Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy
Ryo Maemoto, Shingo Tsujinaka, Yasuyuki Miyakura, Rintaro Fukuda, Nao Kakizawa, Tsutomu Takenami, Erika Machida, Nozomi Kikuchi, Rina Kanemitsu, Sawako Tamaki, Hideki Ishikawa, Toshiki Rikiyama
Asian Journal of Surgery.2021; 44(8): 1037. CrossRef
RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS OF ILEAL POUCH IN PATIENTS WITH ULCERATIVE COLITIS
S. I. Achkasov, O. I. Sushkov, A. E. Kulikov, Sh. A. Binnatli, M. A. Nagudov, A. V. Vardanyan
Koloproktologia.2020; 19(1): 51. CrossRef
A Common Complication After an Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Small Bowel Obstruction
Chang-Nam Kim
Annals of Coloproctology.2018; 34(2): 57. CrossRef
Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
Surgery Today.2018; 48(12): 1060. CrossRef

Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial: Mina Alvandipour, Babak Gharedaghi, Hamed Khodabakhsh, Mohammad Yasin Karami; Ann Coloproctol. 2016;32(4):144-149. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.144

5,989 View
77 Download
18 Web of Science
22 Citations

Abstract PDF

Purpose

Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound.

Methods

This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire.

Results

Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043).

Conclusion

After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.

Citations

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Chisato Shirakawa, Yuzuru Sakamoto, Shinya Ueki, Hiroki Shomura, Keizo Kazui, Akinobu Taketomi
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Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw
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Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo
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Sumesh Kaistha, Rajesh Panwar, Sujoy Pal, Nihar Ranjan Dash, Peush Sahni, Tushar Kanti Chattopadhyay
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Shahnam Askarpour, Mehran Peyvasteh, Farbod Farhadi, Hazhir Javaherizadeh
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Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi
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Jia Gang Han, Hong Wei Yao, Jian Ping Zhou, Hong Zhang, Gui Ying Wang, Zhan Long Shen, Jian Feng Gong, Zhen Jun Wang
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Emanuele Rausa, M. E. Kelly, G. Sgroi, V. Lazzari, A. Aiolfi, F. Cavalcoli, G. Bonitta, L. Bonavina
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M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi
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Italian guidelines for the surgical management of enteral stomas in adults
F. Ferrara, D. Parini, A. Bondurri, M. Veltri, M. Barbierato, F. Pata, F. Cattaneo, A. Tafuri, C. Forni, G. Roveron, G. Rizzo
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