scholarly journals Effect of sham feeding on postoperative ileus

2020 ◽  
Author(s):  
Ilker Ozgur ◽  
Bora Karip ◽  
Metin Keskin ◽  
Ahmet Yalin Iscan ◽  
Emre Balik
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Postoperative Ileus ◽  
Neoadjuvant Treatment ◽  
Nicotine Gum ◽  
Diverting Ileostomy ◽  
Sham Feeding ◽  
Gum Chewing ◽  
Intestinal Movement ◽  
Perioperative Bleeding

Abstract Background: To evaluate the effects of different sham feeding methods on postoperative ileus after low anterior resection and diverting ileostomy for rectal cancer.Methods: 72 patients who underwent low anterior resection with a diverting ileostomy were randomized into 4 groups as: control (n = 16), ice cream (n = 18), gum (n = 17) and nicotine gum (n = 17). Four patients were excluded due to a lack of data. Patients’ demographics, constipation scores, neoadjuvant treatment, amount of perioperative bleeding, fluid administration, drain placement, time of intestinal movement, ileostomy discharge, and return of appetite were compared.Results: Patients’ demographics, constipation scores, neoadjuvant treatment existence, amount of perioperative bleeding, fluid administration, drain placement were similar between groups (p > 0,05). The first sense of intestinal movement was shorter in the nicotine group than control and gum groups (p=0,004 and 0,046, respectively). The average time to first ileostomy discharge and first appetite was shortest in the nicotine gum group. Diverting ileostomy discharge time was significantly shorter in the nicotine gum group than the control group (p=0,011). Return of appetite time was shorter in the nicotine gum group when compared to the gum group (p=0.036).Conclusions: Nicotine gum chewing is an effective method to resolve postoperative ileus after rectal surgery. Other methods such as ice-cream feeding and gum chewing showed no benefit compared to control.

scholarly journals Diverting ileostomy versus no diversion after low anterior resection for rectal cancer: A prospective, randomized, multicenter trial

Surgery ◽  
2016 ◽  
Vol 159 (4) ◽  
pp. 1129-1139 ◽  
Author(s):  
Karl Mrak ◽  
Stefan Uranitsch ◽  
Florian Pedross ◽  
Andreas Heuberger ◽  
Anton Klingler ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Multicenter Trial ◽  
Diverting Ileostomy

scholarly journals Low anterior resection syndrome score among Nepalese population undergoing lower anterior resection for rectal carcinoma

2018 ◽  
Vol 7 (2) ◽  
pp. 59-63
Author(s):  
Dhiresh Kumar Maharjan ◽  
SC Acharya ◽  
PB Thapa
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Functional Results ◽  
Diverting Ileostomy ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Medical College ◽  
Ultralow Anterior Resection ◽  
Lower Anterior Resection

Background: With more sphincters preserving surgery being performed for distal rectal cancer, these have been associated with clusters of symptoms experienced by the patient after reversal of diverting ileostomy collectively known as low anterior resection syndrome.Objective: Our objective is to know incidence of Lower Anterior Resection (LAR) syndrome in different phase of time in our context using low anterior resection symptom score translate in Nepali language.Methodology: This is an observational descriptive study conducted at Department of Surgery, Kathmandu Medical College and Department of Clinical Oncology, Bir Hospital, Kathmandu from Jan 2015 till Jan 2017. All patients who had undergone low and ultra low anterior resection for middle and low rectal cancer respectively after a long course of neo adjuvant concurrent chemo radiotherapy, having undergone a reversal of diverting ileostomy after 6 weeks of primary surgery were included. A Nepalese version of low anterior resection score was developed after translation from English and scoring was done on 30th day, at the end of 6 months and 1 year postoperative following reversal of ileostomy.Results: Out of 43 consecutive patient 100 % of patients had features of major low anterior resection syndrome during 30 days of ileostomy reversal. However, 46.5% patient showed major low anterior resection syndrome during 6 months of follow up and that decreased to 34.9% showed major LAR syndrome upon one year of follow up.Conclusions: The Low anterior resection syndrome score converted in Nepali language is feasible to use and helps in comparing the functional results of reconstruction after low or ultralow anterior resection and our study have shown improvement in score with time. Journal of Kathmandu Medical College,Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 59-63 

Complications of Diverting Ileostomy after Low Anterior Resection for Rectal Carcinoma

2016 ◽  
Vol 82 (10) ◽  
pp. 1033-1037 ◽  
Author(s):  
Sean Maroney ◽  
Carlos Chavez De Paz ◽  
Marjunphilip Duldulao ◽  
Tracey Kim ◽  
Mark E. Reeves ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Medical Center ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Tumor Location ◽  
Diverting Ileostomy ◽  
Loma Linda University ◽  
The Difference

There have been few studies directly comparing the postoperative complications in patients with a diverting ileostomy to patients who were not diverted after low anterior resection (LAR) for rectal carcinoma. This study is a retrospective chart review of all rectal carcinoma patients (99) who underwent a LAR from January 2009 to December 2014 at Loma Linda University Medical Center and Veterans Affairs Loma Linda Healthcare System. A majority of patients were diverted (58% vs 42%). The diverted patients were more likely to have a low tumor location ( P < 0.01), preoperative chemoradiation ( P < 0.01), and more intraoperative blood loss ( P < 0.01). Our study shows a statistically significant higher overall complication rate among patients receiving a diverting ileostomy in the six months after LAR (61% vs 38%, P = 0.02). The difference is due to a higher rate of readmission (27% vs 14%) and acute kidney injury (14% vs 5%) in patients with a diverting ileostomy. It also shows that there is a higher rate of unplanned reoperation (11% vs 6%) due to anastomotic leak (17% vs 5%) in nondiverted patients. Further studies are needed to refine the specific indications to maximize the benefit of diverting ileostomy after LAR for rectal carcinoma.

scholarly journals Predictors of High-Output Stoma After Low Anterior Resection With Diverting Ileostomy for Rectal Cancer

2017 ◽  
Vol 102 (7-8) ◽  
pp. 313-317 ◽  
Author(s):  
Jongsung Pak ◽  
Mamoru Uemura ◽  
Yasunari Fukuda ◽  
Masakazu Miyake ◽  
Masataka Ikeda ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Albumin Level ◽  
Diverting Ileostomy ◽  
Preoperative Serum ◽  
Preoperative Albumin ◽  
High Output

Background: The aim of this study was to identify predictors of high-output stoma (HOS) after low anterior resection (LAR) with diverting ileostomy for rectal cancer. Methods: The medical records of 60 patients who underwent LAR with diverting ileostomy for rectal cancer between 2012 and 2015 were reviewed. HOS was defined as ileostomy output greater than 1500 mL per 24 hours. Patient and surgical characteristics and patient laboratory data were examined to assess for predictors of HOS using univariate and multivariate logistic regression. Results: The incidence of HOS was 43.3% (26/60). In univariate analysis, age ≥ 70 years, diabetes mellitus (DM), preoperative albumin level ≤ 4.0 g/dL, and preoperative serum hemoglobin level ≤ 12 g/dL were significantly associated with HOS. Multivariate analysis identified DM (odds ratio, 9.74; 95% confidence interval, 1.86–77.3) as an independent predictor of HOS. Conclusions: DM might be a predictor of HOS in patients undergoing LAR with diverting ileostomy for rectal cancer.

Nicotine gum chewing: A novel strategy to shorten duration of postoperative ileus via vagus nerve activation

2014 ◽  
Vol 83 (3) ◽  
pp. 352-354 ◽  
Author(s):  
Z. Wu ◽  
G.S.A. Boersema ◽  
J. Jeekel ◽  
J.F. Lange
Keyword(s):  
Vagus Nerve ◽  
Postoperative Ileus ◽  
Nicotine Gum ◽  
Gum Chewing ◽  
Novel Strategy

scholarly journals 417 - Neoadjuvant Treatment Strategy and Correlation with Functional Outcomes after Low Anterior Resection for Rectal Cancer

2018 ◽  
Vol 154 (6) ◽  
pp. S-1268
Author(s):  
Felipe F. Quezada ◽  
Rosa M. Jimenez-Rodriguez ◽  
Emmanouil Pappou ◽  
Jesse Joshua Smith ◽  
Iris H. Wei ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Treatment Strategy ◽  
Functional Outcomes ◽  
Low Anterior Resection ◽  
Neoadjuvant Treatment

scholarly journals Short-Term Outcome Analysis of Temporary Ostomy in Low Anterior Resection for Rectal Cancer-A Retrospective Study

2021 ◽  
Author(s):  
Chuanduo Zhao ◽  
Sicheng Zhou ◽  
Hao Su ◽  
Jianwei Liang ◽  
Zhixiang Zhou
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Operating Time ◽  
Neoadjuvant Treatment ◽  
Clinical Situation ◽  
Outcome Analysis ◽  
Term Outcome ◽  
Matching Criteria

Abstract Background Temporary ostomy has proved to be an effective method to reduce anastomotic leakage in low anterior resection. However, the injury of additional reversal surgery and ostomy-related complications require more evaluation regarding its necessity and feasibility. In this study, we analyzed the outcomes of temporary ostomy in low anterior resection to provide more evidence for surgeons to make clinical decisions.Methods A total of 279 consecutive patients with rectal cancer with temporary ostomy were matched 1:1 to contemporaneous 279 controls without temporary ostomy at our institution to compare the perioperative clinical situation. The matching criteria included age, body mass index (BMI), American Society of Anesthesiology (ASA) score, and tumor stage. The one-year follow-up data was collected to evaluate ostomy-related outcomes.Results The non-ostomy group had a higher proportion of chemoradiotherapy (39.4% vs 10.0%, P < 0.001) and a lower site of anastomosis (6.0 cm vs. 9.0 cm, P < 0.001) than the ostomy group. The ostomy group had a lower rate of anastomotic leakage (0.4% vs 3.6%, P = 0.039), reduced reoperation rate (0.4% vs 2.9%, P = 0.044), longer operating time (214.9 min vs. 151.4 min, P = 0.009) and shorter time to first flatus (3.4 days vs. 4.1 days, P = 0.005) than the non-ostomy group. The safety of reversal surgery is acceptable; however, 21.1% of ostomates did not complete the reversal operation for various reasons within 1 year after the first operation. Age (P = 0.029) and AJCC stage (P = 0.043) may be important factors affecting the closure of ostomy.Conclusions Although time-consuming, temporary ostomy is a good option for high-risk patients to reduce the rates of anastomotic leakage and reoperation in low anterior resection. Considering the ostomy-related inconveniences in daily living, other related complications and rather high proportion of non-reversal, the scope of application should be more for patients with low anastomosis and neoadjuvant treatment.

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