Management of the Patient with a Retracted Loop Ileostomy Located in a Crease

Total colonic aganglionosis (TCA) extended to the ileum is seen quite rare among infants with Hirschsprung's disease. Type and timing of definitive surgery in these patients are controversial. This report was presented to discuss the management of two siblings with TCA. Case 1: A two-day-old girl was operated for partial intestinal obstruction. During laparotomy, serial frozen biopsies proved TCA extended to the terminal ileum and a loop ileostomy was performed. At five months of age, a modified Duhamel-Martin procedure without protective ileostomy was performed. An endo-GIA stapler was transanally used for colo-ileal anastomosis. She is doing well for the last five years. Case 2: A one-day-old boy admitted to the hospital with similar findings to his sister. Frozen biopsies during first laparotomy proved that majority of ileum and entire colon was aganglionic and a proximal ileostomy was performed. At 10 months of age, he underwent a similar Duhamel-Martin operation. He is in a good condition for the last four years. Conclusion: In infants, our modification on Duhamel-Martin procedure, which is based on the use of an endo-GIA stapler transanally for colo-ileal anastomosis without protective ileostomy, may be utilized as an alternative method in the definitive treatment of patients with TCA.

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How to do laparoscopic loop ileostomy or colostomy

ANZ Journal of Surgery ◽

10.1111/ans.15928 ◽

2020 ◽

Vol 90 (9) ◽

pp. 1760-1761

Author(s):

Ankur Sidhu ◽

Eric Daniel ◽

Andrew Bui ◽

Neil Strugnell ◽

Basil D'Souza

Keyword(s):

Loop Ileostomy

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Clinical complications in patients with primary and recurrent Clostridioides difficile infection: A real-world data analysis

SAGE Open Medicine ◽

10.1177/2050312120986733 ◽

2021 ◽

Vol 9 ◽

pp. 205031212098673

Author(s):

Paul Feuerstadt ◽

Mena Boules ◽

Laura Stong ◽

David N Dahdal ◽

Naomi C Sacks ◽

...

Keyword(s):

Loop Ileostomy ◽

Charlson Comorbidity Index Score ◽

Real World Data ◽

Infection Group ◽

Bowel Surgery ◽

Clinical Complications ◽

Clostridioides Difficile ◽

Clostridioides Difficile Infection ◽

Infection Episode

Objective: Clostridioides difficile infection and recurrent C. difficile infection result in substantial economic burden and healthcare resource use. Sepsis and bowel surgery are known to be serious complications of C. difficile infection. This study evaluated clinical complications in patients with C. difficile infection and recurrent C. difficile infection during a 12-month period following the primary C. difficile infection. Methods: A retrospective analysis of commercial claims data from the IQVIA PharMetrics Plus™ database was conducted for patients aged 18–64 years with an index C. difficile infection episode requiring inpatient stay or an outpatient visit for C. difficile infection followed by a C. difficile infection treatment. Each C. difficile infection episode ended after a 14-day C. difficile infection-claim-free period was observed. Recurrent C. difficile infection was defined as a further C. difficile infection episode within an 8-week window following the claim-free period. Clinical complications were documented over 12 months of follow-up and stratified by the number of recurrent C. difficile infection episodes (0 rCDI, 1 rCDI, 2 rCDI, and 3+ rCDI). Results: In total, 46,571 patients with index C. difficile infection episode were included. During the 6-month pre-index, the mean (standard deviation) baseline Charlson comorbidity index score, by increasing the recurrent C. difficile infection group, was 1.2 (1.9), 1.5 (2.2), 1.8 (2.3), and 2.3 (2.5). During the 12-month follow-up, sepsis occurred in 16.5%, 27.3%, 33.1%, and 43.3% of patients, and subtotal colectomy or diverting loop ileostomy was performed in 4.6%, 7.3%, 8.9%, and 10.5% of patients, respectively, by increasing the recurrent C. difficile infection group. Conclusions: Reduction in recurrent C. difficile infection is an important step to reduce the burden of serious clinical complications, and new treatments are needed to reduce C. difficile infection recurrence.

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Postoperative Ileus after Stimulation with Probiotics before Ileostomy Closure

Nutrients ◽

10.3390/nu13020626 ◽

2021 ◽

Vol 13 (2) ◽

pp. 626

Author(s):

Ángela Rodríguez-Padilla ◽

Germán Morales-Martín ◽

Rocío Pérez-Quintero ◽

Juan Gómez-Salgado ◽

Rafael Balongo-García ◽

...

Keyword(s):

Colorectal Carcinoma ◽

Postoperative Ileus ◽

Loop Ileostomy ◽

Bowel Function ◽

Ileostomy Closure ◽

Controlled Study ◽

Control Group ◽

Double Blind ◽

Colorectal Cancer Surgery ◽

Stimulation Of

Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.

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Extended duration of faecal diversion is associated with increased ileus upon loop ileostomy reversal

Colorectal Disease ◽

10.1111/codi.15739 ◽

2021 ◽

Author(s):

Keegan Guidolin ◽

Flora Jung ◽

Richard Spence ◽

Fayez Quereshy ◽

Sami Chadi

Keyword(s):

Loop Ileostomy ◽

Ileostomy Reversal ◽

Faecal Diversion ◽

Extended Duration

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Comparison of the clinical outcomes of skin bridge loop ileostomy and traditional loop ileostomy in patients with low rectal cancer

Scientific Reports ◽

10.1038/s41598-021-88674-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hui Ye ◽

Shujuan Huang ◽

Jie Yu ◽

Qichang Zhou ◽

Changlei Xi ◽

...

Keyword(s):

Rectal Cancer ◽

Low Anterior Resection ◽

Clinical Evidence ◽

Loop Ileostomy ◽

Loop Group ◽

Clinical Results ◽

Low Rectal Cancer ◽

Analog Scale ◽

Traditional Group ◽

Bridge Group

AbstractTo compare the clinical results of patients with low rectal cancer who underwent skin bridge loop ileostomy and traditional loop ileostomy, and provide clinical evidence for choosing a better ostomy method. We retrospectively collected data of 118 patients with rectal cancer who underwent low anterior resection and loop ileostomy. To investigate the patients characteristics, postoperative stoma-related complications and the frequency of exchanged ostomy bags. The differences of these indicators between the two groups of patients who underwent skin bridge loop ileostomy and traditional loop ileostomy were compared. The Visual Analog Scale (VAS) score of the skin bridge loop ileostomy group was lower than that of the traditional ileostomy loop group (P < 0.05). The skin bridge group had a lower Discoloration, Erosion, Tissue overgrowth (DET) score and incidence of mucocutaneous separation than the traditional group at the 1st and 2nd weeks after operation (P < 0.05). The average number of weekly exchanged ostomy bags was significantly less in the skin bridge group than in the traditional group within 4 weeks after surgery (P < 0.05). Our experience demonstrates that the skin bridge loop ileostomy may significantly reduce early postoperative stoma-related complications, the frequency of exchanged ostomy bags and patients’ medical costs after discharge.

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