Loop ileostomy or loop colostomy: which one is better for fecal diversion?

Objective: Low pelvic anastomoses are associated with a high leak rate. Loop ileostomies are commonly performed during ileoanal and coloanal anastomoses. This study was undertaken to review our experience with loop ileostomy closure after low anterior rectal resection and restorative proctocolectomy. Patients and methods: One hundred sixty five patients undergoing loop ileostomy closure at a single institution after coloanal and ileoanal anastomoses for rectal carcinoma (n=148) ulcerative colitis (n=9) and FAP (n=8) from January 2003 to December 2006. Fecal diversion was maintained for a mean 13,5 weeks. Results: Of the 165 patients, 100 were male and 65 female with mean age 59 (range 23-83 years). Overall, complication rate was 10,9 per cent. The common complication were sub occlusion six patients, occlusion three patients, wound infection eight patients and abdominal sepsis one patient. Complications required operative management in four cases. There was no mortality related to ileostomy. Conclusion: The study shown that ileostomy closure is a safe and effective with generally minor complications and should be considered as a safe alterative for fecal diversion.

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Parastomal hernia repair with onlay mesh remains a safe and effective approach

BMC Surgery ◽

10.1186/s12893-020-00964-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Marie Shella De Robles ◽

Christopher J. Young

Keyword(s):

Mesh Repair ◽

Parastomal Hernia ◽

Loop Ileostomy ◽

Wound Complication ◽

Loop Colostomy ◽

Wound Complications ◽

Parastomal Hernia Repair ◽

Significant Difference ◽

Onlay Mesh ◽

Midline Approach

Abstract Background Parastomal hernia (PSH) management poses difficulties due to significant rates of recurrence and morbidity after repair. This study aims to describe a practical approach for PSH, particularly with onlay mesh repair using a lateral peristomal incision. Methods This is a retrospective review of consecutive patients who underwent PSH repair between 2001 and 2018. Results Seventy-six consecutive PSH with a mean follow-up of 93.1 months were reviewed. Repair was carried out for end colostomy (40%), end ileostomy (25%), ileal conduit (21%), loop colostomy (6.5%) end-loop colostomy (5%) and loop ileostomy (2.5%). The repair was performed either with a lateral peristomal incision (59%) or a midline incision (41%). Polypropylene mesh (86%), biologic mesh (8%) and composite mesh (6%) were used. Stoma relocation was done in 9 patients (12%). Eight patients (11%) developed postoperative wound complications. Recurrence occurred in 16 patients (21%) with a mean time to recurrence at 29.4 months. No significant difference in wound complication and recurrence was observed based on the type of stoma, incision used, type of mesh used, and whether or not the stoma was repaired on the same site or relocated. Conclusion Onlay mesh repair of PSH remains a practical and safe approach and could be an advantageous technique for high-risk patients. It can be performed using a lateral peristomal incision with low morbidity and an acceptable recurrence rate. However, for patients with significant adhesions and very large PSH, a midline approach with stoma relocation may also be considered.

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Case Report of a Novel Technique for Fecal Diversion

The American Surgeon ◽

10.1177/00031348211054062 ◽

2021 ◽

pp. 000313482110540

Author(s):

Quyen Chu ◽

Tyler S. Briley

Keyword(s):

Loop Ileostomy ◽

Anastomotic Dehiscence ◽

The United States ◽

Fecal Diversion ◽

Immunocompromised Patients ◽

Significant Morbidity ◽

Novel Technique ◽

States Experience ◽

Perforated Colon

An estimated 100,000 individuals within the United States experience operations that result in a colostomy or ileostomy each year. Ostomy formation is used in surgery for operations involving several pathologies involving the small intestine or colon. Evidence shows that loop ileostomy or loop colostomy for fecal diversion effectively reduce the complications of anastomotic dehiscence. Anastomotic leak can cause significant morbidity and mortality. The role of temporary fecal diversion though a loop ileostomy or colostomy is vital in protecting tenuous anastomoses in the pelvis, immunocompromised patients, or those who are septic. 4 We present a case of a patient with a perforated colon cancer who required an innovative technique for fecal diversion.

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Laparoscopic loop ileostomy for fecal diversion

Diseases of the Colon & Rectum ◽

10.1007/bf02054418 ◽

1994 ◽

Vol 37 (7) ◽

pp. 721-722 ◽

Cited By ~ 12

Author(s):

Per Jess ◽

John Christiansen

Keyword(s):

Loop Ileostomy ◽

Fecal Diversion

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Free Colonic Perforation in a Patient With Crohn's Disease and Loop Ileostomy: Report of a Case

International Surgery ◽

10.9738/1388.1 ◽

2011 ◽

Vol 96 (2) ◽

pp. 159-161 ◽

Cited By ~ 2

Author(s):

Soichiro Ishihara ◽

Toshiaki Watanabe ◽

Hirokazu Nagawa

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Rare Complication ◽

Bowel Perforation ◽

Loop Ileostomy ◽

Disease Patient ◽

Perianal Abscess ◽

Colonic Perforation ◽

Fecal Diversion ◽

Unusual Complication

Abstract Free bowel perforation in Crohn's disease is a relatively rare complication. In this report, we present a case of free colonic perforation in a Crohn's disease patient with loop ileostomy previously constructed for intractable perianal abscess. Normally, fecal diversion by ileostomy results in an improvement in Crohn's colitis. However, in some cases, fecal diversion is reported to adversely affect the inflammation of the diverted bowel, and it is this unusual complication of Crohn's disease that we discuss here.

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