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.
Purpose A consensus has been reached regarding diverting stoma (DS) construction in rectal cancer surgery to avoid reoperation related to anastomotic leakage. However, the incidence of stoma-related complications (SRCs) remains high. In this study, we examined the perioperative outcomes of DS construction in patients who underwent sphincter-preserving surgery for rectal cancer.
Methods We included 400 participants who underwent radical sphincter-preserving surgery for rectal cancer between 2005 and 2017. These participants were divided into the DS (+) and DS (–) groups, and the outcomes, including postoperative complications, were compared.
Results The incidence of ileus was higher in the DS (+) group than in the DS (–) group (P<0.01); however, no patients in the DS (+) group showed grade 3 anastomotic leakage. Furthermore, early SRCs were observed in 33 patients (21.6%) and bowel obstruction-related stoma outlet syndrome occurred in 19 patients (12.4%). There was no significant intergroup difference in the incidence of grade 3b postoperative complications. However, the most common reason for reoperation was different in the 2 groups: anastomotic leakage in 91.7% of patients with grade 3b postoperative complications in the DS (–) group, and SRCs in 85.7% of patients with grade 3b postoperative complications in the DS (+) group.
Conclusion Patients with DS showed higher incidence rates of overall postoperative complications, severe postoperative complications (grade 3), and bowel obstruction, including stoma outlet syndrome, than patients without DS. Therefore, it is important to construct an appropriate DS to avoid SRCs and to be more selective in assigning patients for DS construction.
Citations
Citations to this article as recorded by
Effects of Diverting Stoma Creation in Minimally Invasive Surgery for Rectal Cancer Hirotaka Momose, Makoto Takahashi, Masaya Kawai, Kiichi Sugimoto, Hiromitsu Takahashi, Shunsuke Motegi, Kumpei Honjo, Yu Okazawa, Rina Takahashi, Shun Ishiyama, Yuichi Tomiki, Kazuhiro Sakamoto Journal of the Anus, Rectum and Colon.2025; 9(1): 88. CrossRef
Prevalence and pooled risk factors of stoma outlet obstruction after colorectal surgery with diverting ileostomy: a systematic review and meta-analysis Jian-xin Gan, Hai-peng Liu, Kang Chen International Journal of Colorectal Disease.2025;[Epub] CrossRef
A multicentre prospective study of anal function after laparoscopic ultra‐low rectal cancer surgery using a mixed‐effects model Makoto Takahashi, Kazuhiro Sakamoto, Yuichiro Tsukada, Shingo Kawano, Jun Watanabe, Yosuke Fukunaga, Yasumitsu Hirano, Hiroki Hamamoto, Masanori Yoshimitsu, Hisanaga Horie, Nobuhisa Matsuhashi, Yoshiaki Kuriu, Shuntaro Nagai, Madoka Hamada, Shinichi Yoshi Colorectal Disease.2025;[Epub] CrossRef
The Effectiveness of Adipose Tissue-Derived Mesenchymal Stem Cells Mixed with Platelet-Rich Plasma in the Healing of Inflammatory Bowel Anastomoses: A Pre-Clinical Study in Rats Georgios Geropoulos, Kyriakos Psarras, Maria Papaioannou, Vasileios Geropoulos, Argyri Niti, Christina Nikolaidou, Georgios Koimtzis, Nikolaos Symeonidis, Efstathios T. Pavlidis, Georgios Koliakos, Theodoros E. Pavlidis, Ioannis Galanis Journal of Personalized Medicine.2024; 14(1): 121. CrossRef
Postoperative outcomes and identification of risk factors for complications after emergency intestinal stoma surgery – a multicentre retrospective study Scott MacDonald, Li‐Siang Wong, Hwei Jene Ng, Claire Hastings, Immogen Ross, Tara Quasim, Susan Moug Colorectal Disease.2024; 26(5): 994. CrossRef
Nomogram for predicting the probability of rectal anastomotic re-leakage after stoma closure: a retrospective study Yuegang Li, Gang Hu, Jinzhu Zhang, Wenlong Qiu, Shiwen Mei, Xishan Wang, Jianqiang Tang BMC Cancer.2024;[Epub] CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein Gyung Mo Son Annals of Coloproctology.2024; 40(5): 415. CrossRef
Effect of intraoperative anastomotic reinforcement suture on the prevention of anastomotic leakage of double-stapling anastomosis for laparoscopic rectal cancer: a systematic review and meta-analysis Chaoyang Wang, Xiaolong Li, Hao Lin, Jiahua Ju, Haibao Zhang, Yongjiang Yu Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Stoma prolapse can usually be managed conservatively by stoma care nurses. However, surgical management is considered when complications make traditional care difficult and/or stoma prolapse affects normal bowel function and induces incarceration. If the stoma functions as a fecal diversion, the prolapse is resolved by stoma reversal. Loop stoma prolapse reportedly occurs when increased intraabdominal pressure induces stoma prolapse by pushing the stoma up between the abdominal wall and the intestine, particularly in cases of redundant or mobile colon. Therefore, stoma prolapse repair aims to prevent or eliminate the space between the abdominal wall and the intestine, as well as the redundant or mobile intestine. Accordingly, surgical repair methods for stoma prolapse are classified into 3 types: methods to fix the intestine, methods to shorten the intestine, and methods to eliminate the space between the stoma and the abdominal wall around the stoma orifice. Additionally, the following surgical techniques at the time of stoma creation are reported to be effective in preventing stoma prolapse: an avoidance of excessive fascia incision, fixation of the stoma to the abdominal wall, an appropriate selection of the intestinal site for the stoma orifice to minimize the redundant intestine, and the use of an extraperitoneal route for stoma creation.
Citations
Citations to this article as recorded by
Comprehensive nursing management for an older patient with diarrhoea and risk of dehydration Tiago Horta Reis da Silva Gastrointestinal Nursing.2025; 23(2): 89. CrossRef
Incarcerated trans-stomal herniation resembling a stomal prolapse – a case report N Shaikh, RV Blanco, M Vente, R Ebrahim South African Journal of Surgery.2025; 63(1): 31. CrossRef
Non-Operative Considerations in Relation to Parastomal Hernia Z. Malaibari, M. W. Christoffersen, M. Krogsgaard, N. A. Henriksen, K. Andresen, F. Helgstrand, R. Aldemyati, J. Rosenberg Journal of Abdominal Wall Surgery.2025;[Epub] CrossRef
Stoma Complications Aaron J. Dawes, John V. Gahagan Clinics in Colon and Rectal Surgery.2024; 37(06): 387. CrossRef
Management of the Difficult Stoma Clay Merritt, Paola Maldonado Surgical Clinics of North America.2024; 104(3): 579. CrossRef
Ileostomy: Early and Late Complications Francisco Duarte Cerqueira Gomes Girão Santos, Laura Elisabete Ribeiro Barbosa, João Paulo Meireles de Araújo Teixeira Journal of Coloproctology.2024; 44(01): e80. CrossRef
Linear stapler refashioning technique for irreducible stomal prolapse—A video vignette Rajesh S. Shinde, Deep Mashru, Murali V Colorectal Disease.2024; 26(7): 1483. CrossRef
Stomal Prolapse Due to Sidedness of Transverse Loop Colostomy: A Retrospective Cohort Study Takuya Yano, Masanori Yoshimitsu, Chiyomi Ishibashi, Atsuko Nishibara, Kanyu Nakano, Hitoshi Idani, Masazumi Okajima Journal of the Anus, Rectum and Colon.2023; 7(4): 258. CrossRef
Intestinal Stomas—Current Practice and Challenges: An Institutional Review Isam Mazin Juma, Tabarak Qassim, Mirza Faraz Saeed, Aya Qassim, Sana Al-Rawi, Sabrina Al-Salmi, Mustafa Thaer Salman, Ibrahim Al-Saadi, Abdulaziz Almutawea, Eman Aljahmi, Mohamed Khalid Fadhul Euroasian journal of hepato-gastroenterology.2023; 13(2): 115. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery Hyun Gu Lee The Ewha Medical Journal.2023;[Epub] CrossRef
Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.
Citations
Citations to this article as recorded by
Tumor Recurrence at the Colostomy Site: A Rare Case Report and Literature Review Abdelhak Ettaoussi, Ilias El Azhari, Nassima Fakhiri, Abdessamad Majd, Kamal Khadija, Mounir Bouali, Abdelilah El Bakouri, Khalid Khaleq, Khalid El Hattabi European Journal of Medical and Health Research.2025; 3(3): 215. CrossRef
Colostomy‐site carcinoma with primitive phenotype in a rectal cancer patient after achieving pathological complete response with neoadjuvant chemoradiotherapy Takayuki Kodama, Maki Kanzawa, Hiroshi Hasegawa, Shuichi Tsukamoto, Mari Nishio, Manabu Shigeoka, Yu‐ichiro Koma, Tomoo Itoh, Hiroshi Yokozaki Pathology International.2024; 74(1): 33. CrossRef
Metachronous Carcinoma at Colostomy Site Post Abdominoperineal Resection – A Rare Presentation Case Report Muhammed Huzaifa, Ankita Singh, Vaibhav Aggarwal, Anita Dhar Clinical Cancer Investigation Journal.2023; 12(2): 1. CrossRef
Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent Kayleigh A M van Dam, Thaís T T Tweed, Bart de Vries, Henricus J Belgers Journal of Surgical Case Reports.2023;[Epub] CrossRef
Original Articles
Malignant disease, Functional outcomes,Colorectal cancer
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
Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery Sung Uk Bae World Journal of Gastrointestinal Oncology.2025;[Epub] 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
Purpose Malignant large bowel obstruction is a surgical emergency that requires urgent decompression. Stents are increasingly being used, though reported outcomes are variable. We describe our multidisciplinary experience in using stents to manage malignant large bowel obstruction.
Methods All patients undergoing colorectal stent insertion for acute large bowel obstruction in a teaching hospital were included. Outcomes, complications, and length of stay (LOS) were recorded.
Results Over a 7-year period, 73 procedures were performed on 67 patients (37 male, mean age of 76 years). Interventional radiology was involved in all cases. Endoscopic guidance was required in 24 cases (32.9%). In 18 patients (26.9%), treatment intent was to bridge to elective surgery; 16 had successful stent placement; all had subsequent curative resection (laparoscopic resection, 8 of 18; primary anastomosis, 14 of 18). Overall LOS, including both index admission and elective admission, was 16.4 days. Treatment intent was palliative in 49 patients (73.1%). In this group, stents were successfully placed in 41 of 49 (83.7%). Complication rate within 30 days was 20%, including perforation (2 patients), per rectal bleeding (2), stent migration (1), and stent passage (5). Nineteen patients (38.8%) required subsequent stoma formation (6, during same admission; 13, during subsequent admission). Overall LOS was 16.9 days.
Conclusion In our experience colorectal stents can be used effectively to manage malignant large bowel obstruction, with only selective endoscopic input. As a bridge to surgery, most patients can avoid emergency surgery and have a primary anastomosis. In the palliative setting, the complication rate is acceptable and two-thirds avoid a permanent stoma.
PURPOSE This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212
Citations
Citations to this article as recorded by
Factors associated with leakage after reversal of protective stoma in patients with locally advanced rectal cancer following curative resection and anastomosis Miao-Ling Tsai, Ji-Shiang Hung, John Huang, Been-Ren Lin European Journal of Surgical Oncology.2025; 51(8): 108698. CrossRef
Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery Jia-Rui Liu, Jin Zhang, Xiang-Long Duan World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Risk prediction models for permanence of temporary stoma after radical surgery of rectal cancer: a systematic review Wenjing Tan, Shiyin Cai, Juanqin Wu, Wenke Wu, Shan Wang, Yaqiu Li, Lulu Liu, Liping Tang, Ying Cao World Journal of Surgical Oncology.2025;[Epub] CrossRef
Machine learning model for prediction of permanent stoma after anterior resection of rectal cancer: A multicenter study Yang Su, Yanqi Li, Heng Zhang, Wangshuo Yang, Mengdie Liu, Xuelai Luo, Lu Liu European Journal of Surgical Oncology.2024; 50(7): 108386. CrossRef
A nomogram of anastomotic stricture after rectal cancer: a retrospective cohort analysis Yifan Cheng, Zhen Tian, Shuyang Gao, Shuai Zhao, Ruiqi Li, Jiajie Zhou, Qiannan Sun, Daorong Wang Surgical Endoscopy.2024; 38(7): 3661. CrossRef
Impact of diversion ileostomy on postoperative complications and recovery in the treatment of locally advanced upper-half rectal cancer Yangyang Wang, Xiaojie Wang, Shenghui Huang, Heyuan Zhu, Ying Huang Scientific Reports.2024;[Epub] CrossRef
The role of transanal drainage tube in preventing the anastomotic leakage in rectal cancer surgery without a defunctioning stoma: A meta-analysis Yue-Xin Zhang, Tao Jin, Kun Yang The Surgeon.2023; 21(4): e164. CrossRef
Sarcopenic Obesity Is a Risk Factor for Worse Oncological Long-Term Outcome in Locally Advanced Rectal Cancer Patients: A Retrospective Single-Center Cohort Study Peter Tschann, Markus P. Weigl, Patrick Clemens, Philipp Szeverinski, Christian Attenberger, Matthias Kowatsch, Tarkan Jäger, Klaus Emmanuel, Thomas Brock, Ingmar Königsrainer Nutrients.2023; 15(11): 2632. CrossRef
One Decade of Declining Use of Defunctioning Stomas After Rectal Cancer Surgery in the Netherlands: Are We on the Right Track? Erik W. Ingwersen, Paulien J.K. van der Beek, Jan Willem T. Dekker, Susan van Dieren, Freek Daams Diseases of the Colon & Rectum.2023; 66(7): 1003. CrossRef
Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis Jianguo Yang, Yajun Luo, Tingting Tian, Peng Dong, Zhongxue Fu, Irena Ilic Journal of Oncology.2022; 2022: 1. CrossRef
Tailored Management with Highly-Selective Diversion for Low Colorectal Anastomosis: Biochemical Postoperative Follow-Up and Long-Term Results from a Single-Institution Cohort Philippe Rouanet, Marie Selvy, Marta Jarlier, Caroline Bugnon, Guillaume Carrier, Anne Mourregot, Pierre-Emmanuel Colombo, Christophe Taoum Annals of Surgical Oncology.2022; 29(4): 2514. CrossRef
Are risk factors for anastomotic leakage influencing long-term oncological outcomes after low anterior resection of locally advanced rectal cancer with neoadjuvant therapy? A single-centre cohort study Peter Tschann, Markus P. Weigl, Philipp Szeverinski, Daniel Lechner, Thomas Brock, Stephanie Rauch, Jana Rossner, Helmut Eiter, Paolo N. C. Girotti, Tarkan Jäger, Jaroslav Presl, Klaus Emmanuel, Alexander De Vries, Ingmar Königsrainer, Patrick Clemens Langenbeck's Archives of Surgery.2022; 407(7): 2945. CrossRef
Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Anterior Resection of Rectal Cancer and Construction of a Nomogram Prediction Model Keli Wang, Meijiao Li, Rui Liu, Yang Ji, Jin Yan Cancer Management and Research.2022; Volume 14: 2243. CrossRef
Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis VINÍCIUS EVANGELISTA DIAS, PEDRO ALVES SOARES VAZ DE CASTRO, HOMERO TERRA PADILHA, LARA VICENTE PILLAR, LAURA BOTELHO RAMOS GODINHO, AUGUSTO CLAUDIO DE ALMEIDA TINOCO, RODRIGO DA COSTA AMIL, ALEIDA NAZARETH SOARES, GERALDO MAGELA GOMES DA CRUZ, JULIANA MA Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Fatores de risco pré-operatórios associados à fístula anastomótica após colectomia para câncer colorretal: revisão sistemática e metanálise VINÍCIUS EVANGELISTA DIAS, PEDRO ALVES SOARES VAZ DE CASTRO, HOMERO TERRA PADILHA, LARA VICENTE PILLAR, LAURA BOTELHO RAMOS GODINHO, AUGUSTO CLAUDIO DE ALMEIDA TINOCO, RODRIGO DA COSTA AMIL, ALEIDA NAZARETH SOARES, GERALDO MAGELA GOMES DA CRUZ, JULIANA MA Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Risk Factors of Anastomotic Leakage After Anterior Resection for Rectal Cancer Patients Xiang-nan Yu, Lu-ming Xu, Ya-wen Bin, Ye Yuan, Shao-bo Tian, Bo Cai, Kai-xiong Tao, Lin Wang, Guo-bin Wang, Zheng Wang Current Medical Science.2022; 42(6): 1256. CrossRef
Effect of pelvic drain displacement on anastomotic leakage-related morbidity after rectal cancer surgery Ho Yung Lee, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim Journal of Minimally Invasive Surgery.2021; 24(3): 158. CrossRef
Preoperative chemoradiotherapy versus surgery alone for advanced low rectal cancer: a large multicenter cohort study in Japan Tomonori Akagi, Masafumi Inomata, Hajime Fujishima, Meiki Fukuda, Tsuyoshi Konishi, Shunsuke Tsukamoto, Fuminori Teraishi, Heita Ozawa, Keitaro Tanaka, Koya Hida, Yoshiharu Sakai, Masahiko Watanabe Surgery Today.2020; 50(11): 1507. CrossRef
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
Citations to this article as recorded by
Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal Brian Williams, Aubrey Swinford, Jordan Martucci, Johnny Wang, Jordan R. Wlodarczyk, Abhinav Gupta, Kyle G. Cologne, Sarah E. Koller, Christine Hsieh, Marjun P. Duldulao, Joongho Shin Surgery Open Science.2025; 23: 69. CrossRef
Usefulness of a negative pressure wound therapy system for stoma closure Chisato Shirakawa, Yuzuru Sakamoto, Shinya Ueki, Hiroki Shomura, Keizo Kazui, Akinobu Taketomi Journal of Wound Care.2025; 34(2): 106. CrossRef
Circular (purse-string) vs primary skin closure following stoma closure: an up-to-date systematic review and meta-analysis F. Menegon Tasselli, F. Pata, G. Fuschillo, G. Signoriello, A. Bondurri, G. Sciaudone, F. Selvaggi, G. Pellino Techniques in Coloproctology.2025;[Epub] CrossRef
The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial Assad Ameer, Muhammad Bilal Mirza, Nabila Talat Journal of Pediatric Surgery.2024; 59(6): 1186. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review Jinlong Luo, Dan Liu, Junmei Wu, Huaiwu Jiang, Jin Chen, Hua Yang, Lie Yang Medicine.2024; 103(35): e39477. CrossRef
Short-term outcomes following purse-string versus conventional closure of ileostomy wounds in Chinese colorectal cancer patients — a single center retrospective study Yu-Rong Jiao, Xin-Bin Zhou, Yao Ye, Qian Xiao, Xiang-Xing Kong, Ke-Feng Ding, Jun Li Holistic Integrative Oncology.2023;[Epub] CrossRef
Results of application of the technique of the extraperitoneal closure of loop intestinal stoma N. A. Maistrenko, A. A. Sazonov, P. N. Romashchenko, M. V. Zotov Grekov's Bulletin of Surgery.2023; 181(6): 64. CrossRef
Wound Infection After Ileostomy Closure: An Interim Analysis of a Prospective Randomized Study Comparing Primary Versus Circumferential Subcuticular Closure Techniques Sumesh Kaistha, Rajesh Panwar, Sujoy Pal, Nihar Ranjan Dash, Peush Sahni, Tushar Kanti Chattopadhyay Surgical Infections.2023; 24(9): 797. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw Cochrane Database of Systematic Reviews.2022;[Epub] CrossRef
COMPARISON BETWEEN OSTOMY CLOSURE USING PURSE-STRING VERSUS LINEAR IN CHILDREN Shahnam Askarpour, Mehran Peyvasteh, Farbod Farhadi, Hazhir Javaherizadeh ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2022;[Epub] CrossRef
Negative-pressure wound therapy after stoma reversal in colorectal surgery: a randomized controlled trial Francesco M Carrano, Annalisa Maroli, Michele Carvello, Caterina Foppa, Matteo Sacchi, Jacopo Crippa, Giuseppe Clerico, Francesca De Lucia, Elisabetta Coppola, Nadav Ben David, Antonino Spinelli BJS Open.2021;[Epub] CrossRef
Evidence-based adoption of purse-string skin closure for stoma wounds Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi Medical Journal Armed Forces India.2020; 76(2): 185. CrossRef
Gunsight Procedure Versus the Purse-String Procedure for Closing Wounds After Stoma Reversal: A Multicenter Prospective Randomized Trial Jia Gang Han, Hong Wei Yao, Jian Ping Zhou, Hong Zhang, Gui Ying Wang, Zhan Long Shen, Jian Feng Gong, Zhen Jun Wang Diseases of the Colon & Rectum.2020; 63(10): 1411. CrossRef
Quality of life following ostomy reversal with purse-string vs linear skin closure: a systematic review Emanuele Rausa, M. E. Kelly, G. Sgroi, V. Lazzari, A. Aiolfi, F. Cavalcoli, G. Bonitta, L. Bonavina International Journal of Colorectal Disease.2019; 34(2): 209. CrossRef
Purse-string vs. linear skin closure at loop ileostomy reversal: a systematic review and meta-analysis M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi Techniques in Coloproctology.2019; 23(3): 207. CrossRef
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 Techniques in Coloproctology.2019; 23(11): 1037. CrossRef
Purse-string closure versus conventional primary closure of wound following stoma reversal: Meta-analysis of randomized controlled trials Fabio Rondelli, Laura Franco, Ruben Carlo Balzarotti Canger, Graziano Ceccarelli, Cecilia Becattini, Walter Bugiantella International Journal of Surgery.2018; 52: 208. CrossRef
Purse-string skin closure versus linear skin closure techniques in stoma closure: a comprehensive meta-analysis with trial sequential analysis of randomised trials Shahab Hajibandeh, Shahin Hajibandeh, Andrew Kennedy-Dalby, Sheik Rehman, Reza Arsalani Zadeh International Journal of Colorectal Disease.2018; 33(10): 1319. CrossRef
LOOP ILEOSTOMY CLOSURE (review) I. S. Lantsov, A. I. Moskalev, O. I. Sushkov Koloproktologia.2018; (2): 102. CrossRef
The effect of purse-string approximation versus linear approximation of ileostomy reversal wounds on morbidity rates and patient satisfaction: the 'STOMA' trial D. P. O’Leary, M. Carter, D. Wijewardene, M. Burton, D. Waldron, E. Condon, J. C. Coffey, C. Peirce Techniques in Coloproctology.2017; 21(11): 863. CrossRef
Fecal incontinence is a major concern, and its incidence increases with age. Quality of life may decrease due to fecal incontinence after both sphincter-saving surgery and a rectal resection with a permanent stoma. This study investigated quality of life, with regard to fecal incontinency, in elderly patients after rectal-cancer surgery.
Methods
All patients who underwent elective rectal surgery with anastomosis for rectal cancer between December 2008 and June 2012 at two Dutch hospitals were eligible for inclusion. The Wexner and the fecal incontinence quality of life (FIQoL) scores were collected. Young (<70 years of age) and elderly (≥70 years of age) patients were compared.
Results
Seventy-nine patients were included, of whom 19 were elderly patients (24.1%). All diverting stomas that had been placed (n = 60, 75.9%) had been closed at the time of the study. There were no differences in Wexner or FIQoL scores between the young and the elderly patients. Also, there were no differences between patients without a diverting stoma and patients in whom bowel continuity had been restored. Elderly females had significantly worse scores on the FIQoL subscales of coping/behavior (P = 0.043) and depression/self-perception (P = 0.004) than young females. Elderly females scored worse on coping/behavior (P = 0.010) and depression/self-perception (P = 0.036) than elderly males. Young and elderly males had comparable scores.
Conclusion
Quality of life with regard to fecal incontinency is worse in elderly females after sphincter-preserving surgery for rectal cancer. Patients should be informed of this impact, and a definite stoma may be considered in this patient group.
Citations
Citations to this article as recorded by
Analyzing quality of life after low anterior resection for rectal cancer Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati Irish Journal of Medical Science (1971 -).2024; 193(6): 2643. CrossRef
Patient-reported Bowel Function and Bowel-related Quality of Life After Pelvic Radiation for Rectal Adenocarcinoma: The Impact of Radiation Fractionation and Surgical Resection Michael K. Rooney, Brian De, Kelsey Corrigan, Grace L. Smith, Cullen Taniguchi, Bruce D. Minsky, Ethan B. Ludmir, Eugene J. Koay, Prajnan Das, Albert C. Koong, Oliver Peacock, George Chang, Y. Nancy You, Van K. Morris, Graciela Nogueras-González, Emma B. Clinical Colorectal Cancer.2023; 22(2): 211. CrossRef
Functional outcomes and local control are acceptable following hand‐sewn colo‐anal anastomoses for rectal cancer: Results of long‐term follow‐up David Hudson, Fiona Entriken, Rupert Hodder, Michael Warner ANZ Journal of Surgery.2022; 92(3): 390. CrossRef
Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly Stijn H. J. Ketelaers, Maarten van Heinsbergen, Ricardo G. Orsini, F. Jeroen Vogelaar, Joop L. M. Konsten, Grard A. P. Nieuwenhuijzen, Harm J. T. Rutten, Jacobus W. A. Burger, Johanne G. Bloemen Frontiers in Oncology.2022;[Epub] CrossRef
Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: A systematic review Jennie Burch, Claire Taylor, Ana Wilson, Christine Norton European Journal of Oncology Nursing.2021; 52: 101934. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review Eun Jung Park, Seung Hyuk Baik Precision and Future Medicine.2021; 5(4): 164. CrossRef
The Artificial Bowel Sphincter in the Treatment of Fecal Incontinence, Long-term Complications Aart A. van der Wilt, Stéphanie O. Breukink, Rosel Sturkenboom, Laurents P. Stassen, Cornelius G. Baeten, Jarno Melenhorst Diseases of the Colon & Rectum.2020; 63(8): 1134. CrossRef
Health-Related Quality of Life in Older Adults with Colorectal Cancer Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie Current Oncology Reports.2019;[Epub] CrossRef
Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study Loris Trenti, Ana Galvez, Sebastiano Biondo, Alejandro Solis, Francesc Vallribera-Valls, Eloy Espin-Basany, Alvaro Garcia-Granero, Esther Kreisler European Journal of Surgical Oncology.2018; 44(7): 1031. CrossRef
Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy Mariane Messias Reis Lima Silva, Samuel Aguiar Junior, Juliana de Aguiar Pastore, Érica Maria Monteiro Santos, Fábio de Oliveira Ferreira, Ranyell Matheus S. B. Spencer, Vinicius F. Calsavara, Wilson Toshihiko Nakagawa, Ademar Lopes International Journal of Colorectal Disease.2018; 33(8): 1039. CrossRef
Chirurgische Therapie des Karzinoms des unteren Rektumdrittels A. D. Rink coloproctology.2017; 39(6): 411. CrossRef
Quality of Life After a Low Anterior Resection in Elderly Patients Byung Chun Kim Annals of Coloproctology.2016; 32(1): 5. CrossRef
Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma wound.
Methods
This prospective nonrandomized trial enrolled 48 patients who underwent a stoma closure from February 2010 to October 2013. Patients were divided into two groups according to the stoma closing technique: the CPA group (n = 34) and the PC group (n = 14). The incidences of SSI for the two groups were compared, and the patients' satisfaction with the stoma closure was determined by using a questionnaire.
Results
SSI occurred in 3 of 48 patients (6.3%) and was more frequent in the PC group than in the CPA group (3/14 [21.4%] vs. 0/34 [0%], P = 0.021). Time to complete healing after stoma closure in the CPA group was 32 days (range, 14-61 days). Patients in the CPA group were more satisfied with the resulting wound scar (P = 0.043).
Conclusion
After stoma closure, CPA was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to PC. However, with the CPA technique, the time to heal is longer than it is with PC.
Citations
Citations to this article as recorded by
First Experience with the NPseal®: A Novel Mechanically Powered Negative Pressure Dressing Applied to Colorectal Surgery Wounds Johnny Wang, Brian Williams, Jordan R. Wlodarczyk, Abhinav Gupta, Debora Kim, Kyle G. Cologne, Sarah E. Koller, Christine Hsieh, Marjun P. Duldulao, Joongho Shin Surgical Innovation.2025; 32(2): 127. CrossRef
Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal Brian Williams, Aubrey Swinford, Jordan Martucci, Johnny Wang, Jordan R. Wlodarczyk, Abhinav Gupta, Kyle G. Cologne, Sarah E. Koller, Christine Hsieh, Marjun P. Duldulao, Joongho Shin Surgery Open Science.2025; 23: 69. CrossRef
Comparison of Negative Pressure Wound Therapy Systems and Conventional Non-Pressure Dressings on Surgical Site Infection Rate After Stoma Reversal: Systematic Review and Meta-Analysis of Randomized Controlled Trials Elissavet Anestiadou, Stavros Stamiris, Orestis Ioannidis, Savvas Symeonidis, Stefanos Bitsianis, Konstantinos Bougioukas, Thomas Karagiannis, Efstathios Kotidis, Manousos-Georgios Pramateftakis, Ioannis Mantzoros, Angeliki Cheva, Georgios Geropoulos, Chr Journal of Clinical Medicine.2025; 14(5): 1654. CrossRef
Impact of different skin suturing methods on patient prognosis after ileostomy closure Yu-Bo Gao, Liang Wang, Li-Na Shi, Xiao Wu, Wei Miao World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Clinical Benefits of Reducing Dead Space Using a Closed Suction Drain and Subcutaneous Large-bite Buried Suture Technique to Prevent Superficial Surgical-site Infections Following Primary Closure of a Diverting Stoma Yusuke Ohara, Yohei Owada, Jaejeong Kim, Shoko Moue, Yoshimasa Akashi, Koichi Ogawa, Kazuhiro Takahashi, Osamu Shimomura, Kinji Furuya, Shinji Hashimoto, Tsuyoshi Enomoto, Tatsuya Oda Journal of the Anus, Rectum and Colon.2024; 8(2): 70. CrossRef
Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review Jinlong Luo, Dan Liu, Junmei Wu, Huaiwu Jiang, Jin Chen, Hua Yang, Lie Yang Medicine.2024; 103(35): e39477. CrossRef
Gunsight suture with subcutaneous vacuum drainage during enterostomy decreased the surgical site infection rate in obese rectal cancer patients: A retrospective study Lei Zhang, Zhi-Qiang Xiao, Chang-Ling San, Tong-Lin Miao Journal of Nutritional Oncology.2023; 8(3): 151. CrossRef
Effectiveness of negative pressure wound therapy with instillation and dwelling after stoma closure: a retrospective and propensity score matching analysis Yoshinori Yane, Jin-ichi Hida, Yasutaka Chiba, Yusuke Makutani, Hokuto Ushijima, Yasumasa Yoshioka, Masayoshi Iwamoto, Toshiaki Wada, Koji Daito, Tadao Tokoro, Kazuki Ueda, Junichiro Kawamura Scientific Reports.2022;[Epub] CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery Bradley R. Davis, Michael A. Valente, Joel E. Goldberg, Amy L. Lightner, Daniel L. Feingold, Ian M. Paquette Diseases of the Colon & Rectum.2022; 65(10): 1173. CrossRef
The technique for less infectious and earlier healing of stoma closure wound: negative pressure wound therapy with instillation and dwelling followed by primary closure Yoshinori Yane, Jin-ichi Hida, Yusuke Makutani, Hokuto Ushijima, Yasumasa Yoshioka, Masayoshi Iwamoto, Toshiaki Wada, Koji Daito, Tadao Tokoro, Kazuki Ueda, Junichiro Kawamura BMC Surgery.2021;[Epub] CrossRef
Symptoms and Care Satisfaction in Patients Who Underwent Coronary Artery Bypass Graft Surgery Tuğçe BOZKURT Clinical and Experimental Health Sciences.2021; 11(3): 481. CrossRef
Evidence-based adoption of purse-string skin closure for stoma wounds Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi Medical Journal Armed Forces India.2020; 76(2): 185. CrossRef
Gunsight Procedure Versus the Purse-String Procedure for Closing Wounds After Stoma Reversal: A Multicenter Prospective Randomized Trial Jia Gang Han, Hong Wei Yao, Jian Ping Zhou, Hong Zhang, Gui Ying Wang, Zhan Long Shen, Jian Feng Gong, Zhen Jun Wang Diseases of the Colon & Rectum.2020; 63(10): 1411. CrossRef
Purse-string approximation vs. primary closure with a drain for stoma reversal surgery: results of a randomized clinical trial Kunihiko Amamo, Hideyuki Ishida, Kensuke Kumamoto, Norimichi Okada, Satoshi Hatano, Noriyasu Chika, Yusuke Tajima, Tomonori Ohsawa, Masaru Yokoyama, Keiichiro Ishibashi, Erito Mochiki Surgery Today.2019; 49(3): 231. CrossRef
Purse-string vs. linear skin closure at loop ileostomy reversal: a systematic review and meta-analysis M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi Techniques in Coloproctology.2019; 23(3): 207. CrossRef
Incisional hernia following closure of loop ileostomy: The main predictor is the patient, not the surgeon A.J. Brook, S.D. Mansfield, I.R. Daniels, N.J. Smart The Surgeon.2018; 16(1): 20. CrossRef
Purse-string skin closure versus linear skin closure techniques in stoma closure: a comprehensive meta-analysis with trial sequential analysis of randomised trials Shahab Hajibandeh, Shahin Hajibandeh, Andrew Kennedy-Dalby, Sheik Rehman, Reza Arsalani Zadeh International Journal of Colorectal Disease.2018; 33(10): 1319. CrossRef
Effect of a Purse-String Approximation Following Stoma Takedown on Wound Infection and Satisfaction In Ja Park Annals of Coloproctology.2015; 31(1): 7. CrossRef
The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.
Methods
The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.
Results
The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.
Conclusion
Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
Citations
Citations to this article as recorded by
Propensity Score Analysis of the Utility of Supervised Perioperative Abdominal Wall Exercises for the Prevention of Parastomal Hernia Victoria Alejandra López-Callejón, Amparo Yuste-Sanchez, Mayed Murad, Rut Navarro-Martínez, Leticia Pérez-Santiago, José Martín-Arevalo, David Moro-Valdezate, Vicente Pla-Martí, David Casado-Rodriguez, Alejandro Espí-Macías, Stephanie García-Botello Nursing Reports.2025; 15(2): 62. 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
Significance of Specimen Extraction Site in Minimizing Hernia Risk After Distal Pancreatectomy Pranay S. Ajay, Hardik U. Shah, Sameer Sandhu, Caitlin P. Sok, Parit T. Mavani, Subir Goyal, Maria C. Russell, Kenneth Cardona, Felipe B. Maegawa, Shishir K. Maithel, Juan M. Sarmiento, David A. Kooby, Mihir M. Shah Annals of Surgical Oncology.2024; 31(13): 8688. CrossRef
Incidence of incisional hernia after major colorectal cancer surgery & analysis of associated risk factors in Asian population: Is laparoscopy any better? Shao Nan Khor, S.H.X. Cheok, Rehena Sultana, Emile Kwong Wei Tan Asian Journal of Surgery.2023; 46(1): 99. CrossRef
Caracterización de un grupo de pacientes sometidos a herniorrafia lateral con malla retromuscular en un centro de tercer nivel de 2015 a 2019 Carlos Andrés Calle-Lotero, Camila Arias-González, Juliana Mesa-Arango, Estefanía Muñoz-Cuartas, Faber Alveiro Machado-Rivera Revista Colombiana de Cirugía.2023;[Epub] CrossRef
Effect of Obesity Classification on Complications after Sigmoidostomy for Low-Grade Rectal Cancer: A Retrospective Cohort Study 慧 王 Advances in Clinical Medicine.2023; 13(07): 11825. CrossRef
Midline incision vs. transverse incision for specimen extraction is not a significant risk factor for developing incisional hernia after minimally invasive colorectal surgery: multivariable analysis of a large cohort from a single tertiary center in Korea Hong Bae Choi, Dabin Chung, Ji-Seon Kim, Tae-Hoon Lee, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim Surgical Endoscopy.2022; 36(2): 1199. CrossRef
Stoma creation is associated with a low incidence of midline incisional hernia after colorectal surgery: the “fighting over the fascia” theory concerning the incision and stoma hole Noriaki Ohara, Kay Uehara, Atsushi Ogura, Masanori Sando, Toshisada Aiba, Yuki Murata, Takashi Mizuno, Kokuryo Toshio, Yukihiro Yokoyama, Satoko Ishigaki, Yuanying Li, Hiroshi Yatsuya, Tomoki Ebata Surgery Today.2022; 52(6): 953. CrossRef
Collagen Analysis in Incisional Hernias Asha Jose V. Journal of Evolution of Medical and Dental Sciences.2022; 11(2): 335. CrossRef
Impact of a Dual-Ring Wound Protector on Outcome After Elective Surgery for Colorectal Cancer Chin-Fan Chen, Hsiang-Lin Tsai, Ching-Wen Huang, Yung-Sung Yeh, Cheng-Jen Ma, Tsung-Kun Chang, Wei-Chih Su, Jaw-Yuan Wang Journal of Surgical Research.2019; 244: 136. CrossRef
Incidence of Clinically Relevant Incisional Hernia After Colon Cancer Surgery and Its Risk Factors: A Nationwide Claims Study Gi Hyeon Seo, Eun Kyung Choe, Kyu Joo Park, Young Jun Chai World Journal of Surgery.2018; 42(4): 1192. CrossRef
Incidence and Factors Correlating With Incisional Hernia Following Open Bowel Resection in Patients With Inflammatory Bowel Disease Tomas M. Heimann, Santosh Swaminathan, Adrian J. Greenstein, Randolph M. Steinhagen Annals of Surgery.2018; 267(3): 532. CrossRef
Extraperitoneal sigmoidostomy: a surgical approach with less complications and better functions for abdominoperineal resection of rectal cancer Peng Wang, Jianwei Liang, Haitao Zhou, Zheng Wang, Lei Shi, Zhixiang Zhou International Journal of Colorectal Disease.2018; 33(1): 41. CrossRef
Preventive endoprosthetic replacement of the abdominal wall after midline laparotomy N. A. Kulikova Operativnaya khirurgiya i klinicheskaya anatomiya (Pirogovskii nauchnyi zhurnal).2018; 2(3): 38. CrossRef
Discovery of novel plasma proteins as biomarkers for the development of incisional hernias after midline incision in patients with colorectal cancer: The ColoCare study Jürgen Böhm, Frank Pianka, Nina Stüttgen, Junghyun Rho, Biljana Gigic, Yuzheng Zhang, Nina Habermann, Petra Schrotz-King, Clare Abbenhardt-Martin, Lin Zielske, Paul D. Lampe, Alexis Ulrich, Markus K. Diener, Cornelia M. Ulrich Surgery.2017; 161(3): 808. CrossRef
Postoperative abdominal hernia: a modern view on incidence and etiopathogenesis A. S. Ermolov, V. T. Koroshvili, D. A. Blagovestnov, P. A. Yartsev, I. A. Shlyakhovsky Khirurgiya. Zhurnal im. N.I. Pirogova.2017; (5): 76. CrossRef
Risk factors of severe incisional hernia after renal transplantation: a retrospective multicentric case–control study on 225 patients E. Broggi, F. Bruyère, F. Gaudez, F. Desgrandchamps World Journal of Urology.2017; 35(7): 1111. CrossRef
Assessing the predictive accuracy of the American College of Surgeons National Surgical Quality Improvement Project Surgical Risk Calculator in open ventral hernia repair Marten N. Basta, Andrew R. Bauder, Stephen J. Kovach, John P. Fischer The American Journal of Surgery.2016; 212(2): 272. CrossRef
Prevention of postoperative ventral hernias: current state of the art B. S. Sukhovatykh, N. M. Valuyskaya, N. V. Pravednikova, E. V. Gerasimchuk, T. V. Mutova Khirurgiya. Zhurnal im. N.I. Pirogova.2016; (3): 76. CrossRef
Collagenopathies—Implications for Abdominal Wall Reconstruction: A Systematic Review Bridget Harrison, Kyle Sanniec, Jeffrey E. Janis Plastic and Reconstructive Surgery - Global Open.2016; 4(10): e1036. CrossRef
The state of midline closure of the abdominal wall A H Petter-Puchner British Journal of Surgery.2015; 102(12): 1446. CrossRef
Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference Gianfranco Silecchia, Fabio Cesare Campanile, Luis Sanchez, Graziano Ceccarelli, Armando Antinori, Luca Ansaloni, Stefano Olmi, Giovanni Carlo Ferrari, Diego Cuccurullo, Paolo Baccari, Ferdinando Agresta, Nereo Vettoretto, Micaela Piccoli Surgical Endoscopy.2015; 29(9): 2463. CrossRef
Mesh herniorrhaphy with simultaneous colorectal surgery: a case-matched study from the American College of Surgeons National Surgical Quality Improvement Program Cigdem Benlice, Emre Gorgun, Erman Aytac, Gokhan Ozuner, Feza H. Remzi The American Journal of Surgery.2015; 210(4): 766. CrossRef
A review of the incidence of iatrogenic hernia in both laparoscopic and open colorectal surgery: Using CT as the gold standard of detection, cohort study Nader Naguib, Henna Rafique, Pawan Kumar Dhruva Rao, Tomos Longworth, Jean Mark Soukias, Ashraf Masoud International Journal of Surgery.2015; 19: 87. CrossRef
Incidence and Risk Factors of Parastomal Hernia in Patients Undergoing Radical Cystectomy and Ileal Conduit Diversion Nick W. Liu, Jeromy T. Hackney, Paul T. Gellhaus, M. Francesca Monn, Timothy A. Masterson, Richard Bihrle, Thomas A. Gardner, Michael G. House, Michael O. Koch Journal of Urology.2014; 191(5): 1313. CrossRef
Incidence of and risk factors for incisional hernia after abdominal surgery K Itatsu, Y Yokoyama, G Sugawara, H Kubota, Y Tojima, Y Kurumiya, H Kono, H Yamamoto, M Ando, M Nagino British Journal of Surgery.2014; 101(11): 1439. CrossRef
Prophylactic synthetic mesh can be safely used to close emergency laparotomies, even in peritonitis Nuria Argudo, José A. Pereira, Juan J. Sancho, Estela Membrilla, M. José Pons, Luis Grande Surgery.2014; 156(5): 1238. CrossRef
Risk Factors for the Development of Parastomal Hernia after Radical Cystectomy Timothy F. Donahue, Bernard H. Bochner, John P. Sfakianos, Matthew Kent, Melanie Bernstein, William M. Hilton, Eugene K. Cha, Alyssa M. Yee, Guido Dalbagni, Hebert A. Vargas Journal of Urology.2014; 191(6): 1708. CrossRef
Increased Risk of Incisional Hernia after Sigmoid Colectomy for Diverticulitis Compared with Colon Cancer Javier S. Pogacnik, Evangelos Messaris, Susan M. Deiling, Tara M. Connelly, Arthur S. Berg, David B. Stewart, Kevin J. McKenna, Lisa S. Poritz, Walter A. Koltun Journal of the American College of Surgeons.2014; 218(5): 920. CrossRef
The association between stomach cancer and colorectal cancer is controversial. The purpose of this study was to determine the synchronous prevalence of colorectal neoplasms in patients with stomach cancer.
Methods
A total of 123 patients with stomach cancer (86 male) and 246 consecutive, age- and sex-matched persons without stomach cancer were analyzed from July 2005 to June 2010. All of them underwent colonoscopy within 6 months after undergoing gastroscopy.
Results
The prevalence of colorectal neoplasms was significantly higher in the stomach cancer group (35.8%) than in the control group (17.9%) (P < 0.001). Colorectal neoplasms were more prevalent in the patients with stomach cancer (odds ratio [OR], 3.10; 95% confidence interval [CI], 1.71 to 5.63). In particular, the difference in the prevalence of colorectal neoplasms was more prominent in the patients above 50 years old (OR, 3.54; 95% CI, 1.80 to 6.98).
Conclusion
The results showed that the synchronous prevalence of colorectal neoplasms was higher in patients with stomach cancer than in those without stomach cancer. Therefore, patients with stomach cancer should be regarded as a high-risk group for colorectal neoplasms, and colonoscopy should be recommended for screening.
Citations
Citations to this article as recorded by
Colonoscopy plays an important role in detecting colorectal neoplasms in patients with gastric neoplasms Xu-Rui Liu, Ze-Lin Wen, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng World Journal of Gastrointestinal Oncology.2024; 16(1): 133. CrossRef
Retrospective cohort study investigating association between precancerous gastric lesions and colorectal neoplasm risk Hui Pan, Yu-Long Zhang, Chao-Ying Fang, Yu-Dai Chen, Li-Ping He, Xiao-Ling Zheng, Xiaowen Li Frontiers in Oncology.2024;[Epub] CrossRef
Prognostic significance of NUAK1 and its association with immune infiltration in stomach adenocarcinoma Xin Ni, Fan Pan, Ya Kun Lang, Wei Zhang Discover Oncology.2024;[Epub] CrossRef
Genetic analyses supporting colorectal, gastric, and prostate cancer syndromes Karin Wallander, Wen Liu, Susanna von Holst, Jessada Thutkawkorapin, Vinaykumar Kontham, Anna Forsberg, Annika Lindblom, Kristina Lagerstedt‐Robinson Genes, Chromosomes and Cancer.2019; 58(11): 775. CrossRef
Frequency and risk factors of colorectal adenoma in patients with early gastric cancer Hyun H. Chung, Kyeong O. Kim, Si H. Lee, Byung I. Jang, Tae N. Kim Internal Medicine Journal.2017; 47(10): 1184. CrossRef
Is Colonoscopic Screening Necessary for Patients Younger than 50 Years with Gastric Adenoma or Cancer? Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Yoon Suk Jung Journal of Korean Medical Science.2017; 32(8): 1281. CrossRef
Is Preoperative Work-Up Colonoscopy Necessary for Patient with Gastric Cancer? Hee Chan Yang, Ju Hyung Lee, Sung Kyun Yim, Hong-Seon Son, Seung Young Seo, Seong Hun Kim, In Hee Kim, Seung Ok Lee, Soo Teik Lee, Sang Wook Kim The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2016; 16(4): 215. CrossRef
Short-term Outcomes of Laparoscopic Surgery for Synchronous Gastric and Colorectal Cancer Ryoji Makizumi, Shinya Mikami, Kuniyasu Horikoshi, Tsukasa Shimamura, Shinjiro Kobayashi, Akira Hanai, Satoshi Tsukikawa, Yukihito Kokuba, Nobuyoshi Miyajima, Takehito Otsubo Journal of St. Marianna University.2015; 6(2): 273. CrossRef
Clinical Significance of Colonoscopy in Patients with Upper Gastrointestinal Polyps and Neoplasms: A Meta-Analysis Zhen-Jie Wu, Yuan Lin, Jun Xiao, Liu-Cheng Wu, Jun-Gang Liu, John Green PLoS ONE.2014; 9(3): e91810. CrossRef
Role of Preoperative Colonoscopy in Patients with Gastric Cancer: A Case Control Study of the Prevalence of Coexisting Colorectal Neoplasms Han Mo Yoo, Tae Geun Gweon, Ho Seok Seo, Jung Ho Shim, Sung Il Oh, Myung Gyu Choi, Kyo Young Song, Hae Myoung Jeon, Cho Hyun Park Annals of Surgical Oncology.2013; 20(5): 1614. CrossRef
Parastomal hernia is a major complication of an intestinal stoma. This study was performed to compare the results of various operative methods to treat parastomal hernias.
Methods
Results of surgical treatment for parastomal hernias (postoperative recurrence, complications and postoperative hospital stays) were surveyed in 39 patients over an 11-year period. The patients enrolled in this study underwent surgery by a single surgeon to exclude surgeon bias.
Results
Seventeen patients were male, and twenty-two patients were female. The mean age was 65.9 years (range, 36 to 86 years). The stomas were 35 sigmoid-end-colostomies (90%), 2 loop-colostomies (5%), and 2 double-barrel-colostomies. Over half of the hernias developed within two years after initial formation. Stoma relocation was performed in 8 patients, suture repair in 14 patients and mesh repair in 17 patients. Seven patients had recurrence of the hernia, and ten patients suffered from complications. Postoperative complications and recurrence were more frequent in stoma relocation than in suture repair and mesh repair. Emergency operations were performed in four patients (10.3%) with higher incidence of complications but not with increased risk of recurrence. Excluding emergency operations, complications of relocations were not higher than those of mesh repairs. Postoperative hospital stays were shortest in mesh repair patients.
Conclusion
In this study, mesh repair showed low recurrence and a low complication rate with shorter hospital stay than relocation methods, though these differences were not statistically significant. Further studies, including randomized trials, are necessary if more reliable data on the surgical treatment of parastomal hernias are to be obtained.
Citations
Citations to this article as recorded by
Long-term outcomes after open parastomal hernia repair at a high-volume center Alexis M. Holland, William R. Lorenz, Brittany S. Mead, Gregory T. Scarola, Vedra A. Augenstein, B. Todd Heniford, Monica E. Polcz Surgical Endoscopy.2025; 39(1): 639. CrossRef
Parastomal Hernia: direct repair versus relocation: is stoma relocation worth the risk? A comparative meta-analysis and systematic review Ahmed Abdelsamad, Mohammed Khaled Mohammed, Mohamed Badr Almoshantaf, Aya Alrawi, Ziad A. Fadl, Ziad Tarek, Nada Osama Aboelmajd, Torsten Herzog, Florian Gebauer, Nada K. Abdelsattar, Taha Abd-ElSalam Ashraf Taha Updates in Surgery.2025;[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
The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery Andrew S. Miller, Kathryn Boyce, Benjamin Box, Matthew D. Clarke, Sarah E. Duff, Niamh M. Foley, Richard J. Guy, Lisa H. Massey, George Ramsay, Dominic A. J. Slade, James A. Stephenson, Phil J. Tozer, Danette Wright Colorectal Disease.2021; 23(2): 476. CrossRef
Prevention and treatment of parastomal hernia: a position statement on behalf of the Association of Coloproctology of Great Britain and Ireland
Repair of complex parastomal hernias G. S. Hwang, M. H. Hanna, J. C. Carmichael, S. D. Mills, A. Pigazzi, M. J. Stamos Techniques in Coloproctology.2015; 19(3): 127. CrossRef
Systematic review of open techniques for parastomal hernia repair J. Al Shakarchi, J. G. Williams Techniques in Coloproctology.2014; 18(5): 427. CrossRef
Korrektur der parastomalen Hernie mit Netz A. Lampel, N. Runkel Der Urologe.2012; 51(7): 965. CrossRef
Analysis of Risk Factors for the Development of Incisional and Parastomal Hernias in Patients after Colorectal Surgery In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park Journal of the Korean Society of Coloproctology.2012; 28(6): 299. CrossRef
PURPOSE Stoma formation has usually been used for bowel decompression or fecal diversion. For these, a cecostomy is rarely performed because of disadvantages such as incomplete fecal diversion or fatal complications. The aim of this study was to evaluate the usefulness of an open cecostomy in treating patients with colonic obstruction. METHODS Between May 2005 and August 2008, 20 patients underwent an open cecostomy because of colonic obstruction.
All information on the patients was reviewed retrospectively for underlying disease, obstruction site, diameter of the cecum and transverse colon, and complications. RESULTS Of the 20 patients, 14 had colorectal cancer, 3 had stomach cancer, 1 had cervical cancer, 1 had a carcinoid tumor, and 1 had an osteosarcoma. The cause of the obstruction was the primary tumor in 7 patients, peritoneal carcinomatosis in 7 patients, local recurrence in 5, and tissue edema after cyberknife treatment in 1 patient. All patients, except for 1 patient with a hopeless discharge due to rapid disease progression, were discharged on the tenth day postoperatively. No fatal complication developed. In 2 patients, the cecostomy closed spontaneously at 5.5 mo postoperatively after the distal obstruction had been resolved. CONCLUSION An open cecostomy may be a useful and simple method for the decompression of a colonic obstruction, even though the diversion may not be complete.
Citations
Citations to this article as recorded by
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 Annals of Coloproctology.2022; 38(4): 319. CrossRef
Parastomal hernia is not an uncommon complication after stoma formation. Although there are a variety of open surgical techniques, rates of morbidity, recurrence and complications are high. Nowadays, with improvements in techniques and equipment, laparoscopic surgery is being increasingly used in every field of surgery. Herein, we present a case study of a patient suffering from a large parastomal hernia who underwent a laparoscopic hernia repair. A 71-year-old man who had undergone an abdominoperineal resection for an adenocarcinoma of the rectum 5 years ago was admitted to our hospital for a large parastomal hernia, which was repaired by using a laparoscopic approach with Gore-Tex and protack (auto-suture(R), USA). We found the laparoscopic approach for a large parastomal hernia to be technically feasible and to be a good alternative to conventional open surgery with the advantage of minimal invasivess.