Aim Loop ileostomy is a suitable procedure for transitory faecal diversion after colorectal or coloanal anastomosis. We describe here an easy alternative technique for ileostomy construction that does not require reintervention for the closure. Method In twenty patients undergoing anterior resection of the extraperitoneal rectum with colorectal and/or coloanal anastomosis, loop ileostomy was performed using a modified jejunotomy tube inflated with 10 ml of normal saline. The tube was deflated on the eighth post-operative day and removed on day 11 after a radiological contrast enema of the anastomosis. Results Radiological control carried out on day 11 evidenced a premature dislocation of the jejunostomy tube in 1 patient, thus the tube was correctly removed without any complications. In another patient a delayed closure of the ileo cutaneous fistula was recorded that required simple medication over 15 days in the out patient clinic. No signs of anastomotic leakage, either clinical or radiological were evidenced. Conclusion We have described here a safe alternative technique for loop ileostomy with negligible complications related to construction as demonstrated in our results. Indication Diverting loop ileostomy is performed to reduce the effect of anastomotic leakage if it occurs. There is evidence that it may lower its rate [1–8]. We report preliminary data of a new technique of loop ileostomy on a modified jejunostomy tube. Method Twenty (12 men) consecutive patients undergoing anterior resection for rectal cancer, within 3–12 (average 7.4) cm of the anal verge, between March 2009 and October 2009, were included in the study (Table 1). The median age was 64.5 (range 52–85) years. All operations involved a total mesorectal excision (TME) with autonomic nerve preservation as previously described [9]. Nine had an open operation and 13 a laparoscopic operation (Table 1). A modified jejunostomy tube (Fig. 1) was placed in the ileum
Preliminary report of a new technique for temporary fecal diversion after extraperitoneal colorectal anastomosis.
RONDELLI, Fabio;
2010
Abstract
Aim Loop ileostomy is a suitable procedure for transitory faecal diversion after colorectal or coloanal anastomosis. We describe here an easy alternative technique for ileostomy construction that does not require reintervention for the closure. Method In twenty patients undergoing anterior resection of the extraperitoneal rectum with colorectal and/or coloanal anastomosis, loop ileostomy was performed using a modified jejunotomy tube inflated with 10 ml of normal saline. The tube was deflated on the eighth post-operative day and removed on day 11 after a radiological contrast enema of the anastomosis. Results Radiological control carried out on day 11 evidenced a premature dislocation of the jejunostomy tube in 1 patient, thus the tube was correctly removed without any complications. In another patient a delayed closure of the ileo cutaneous fistula was recorded that required simple medication over 15 days in the out patient clinic. No signs of anastomotic leakage, either clinical or radiological were evidenced. Conclusion We have described here a safe alternative technique for loop ileostomy with negligible complications related to construction as demonstrated in our results. Indication Diverting loop ileostomy is performed to reduce the effect of anastomotic leakage if it occurs. There is evidence that it may lower its rate [1–8]. We report preliminary data of a new technique of loop ileostomy on a modified jejunostomy tube. Method Twenty (12 men) consecutive patients undergoing anterior resection for rectal cancer, within 3–12 (average 7.4) cm of the anal verge, between March 2009 and October 2009, were included in the study (Table 1). The median age was 64.5 (range 52–85) years. All operations involved a total mesorectal excision (TME) with autonomic nerve preservation as previously described [9]. Nine had an open operation and 13 a laparoscopic operation (Table 1). A modified jejunostomy tube (Fig. 1) was placed in the ileumI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
