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Erschienen in: European Surgery 5/2014

01.11.2014 | Original Article

Early protective ileostomy closure following stoma formation with a dual-sided absorbable adhesive barrier

verfasst von: MD G. Köhler, MD Doz. Dr. G. Spaun, MD Dr. R.-R. Luketina, MD Dr. S. A. Antoniou, MD Doz. Dr. O. O. Koch, MD Prof. Dr. K. Emmanuel

Erschienen in: European Surgery | Ausgabe 5/2014

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Summary

Background

Usually, a temporary and diverting ileostomy is reversed not earlier than 8 weeks because of adhesions and edema along with vulnerability of the intestinal wall. We aimed to evaluate whether early closure of loop ileostomy during index admission using an antiadhesive bioabsorbable membrane is feasible and safe.

Methods

We included all patients undergoing ileostomy formation due to conventional or laparoscopy-assisted colorectal resections and stoma closure within 2 weeks using a dual-sided film between January 2011 and June 2012. Evaluation comprised patients’ demographic and disease characteristics, with objective to assess the rate and time interval of planned early stoma closure and length of hospital stay. Complications were divided related to stoma formation and closure. Follow-up data were collected by defined oncological aftercare.

Results

A total of 14 patients with a median age of 66 years were included. Median length of hospital stay was 27 days (range, 19–34 days), time between stoma formation and closure was 10 days (range, 8–14 days), and time of discharge was 8 days (range, 6–10 days) after stoma closure. Two complications related to stoma formation occurred in the form of one parastomal hernia and one wound infection. Complications related to stoma closure occured in five patients—one small bowel anastomotic leak in one patient and incisional hernias at stoma site in four patients.

Conclusion

Early ileostomy closure at index admission using an adhesive barrier appears to be a safe alternative to traditional closure.
Literatur
1.
Zurück zum Zitat Chude GG, Rayate NV, Patris V, et al. Defunctioning loop ileostomy with low anterior resection for distal rectal cancer: should we make an ileostomy as a routine procedure? A prospective randomized study. Hepatogastroenterology. 2008;55(86–87):1562–7. PubMed Chude GG, Rayate NV, Patris V, et al. Defunctioning loop ileostomy with low anterior resection for distal rectal cancer: should we make an ileostomy as a routine procedure? A prospective randomized study. Hepatogastroenterology. 2008;55(86–87):1562–7. PubMed
2.
Zurück zum Zitat Schilling MK, Maurer CA, Kollmar O, Büchler MW. Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey stage III and IV): a prospective outcome and cost analysis. Dis Colon Rectum. 2001;44:699. PubMedCrossRef Schilling MK, Maurer CA, Kollmar O, Büchler MW. Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey stage III and IV): a prospective outcome and cost analysis. Dis Colon Rectum. 2001;44:699. PubMedCrossRef
3.
Zurück zum Zitat Brown J, Meyer F, Klapproth JM. Aspects in the interdisciplinary decision-making for surgical intervention in ulcerative colitis and its complications. Z Gastroenterol. 2012;50(5):468–74. doi:10.1055/s-0031-1299467. PubMedCrossRef Brown J, Meyer F, Klapproth JM. Aspects in the interdisciplinary decision-making for surgical intervention in ulcerative colitis and its complications. Z Gastroenterol. 2012;50(5):468–74. doi:10.1055/s-0031-1299467. PubMedCrossRef
4.
Zurück zum Zitat Shabbir J, Britton DC. Stoma complications: a literature overview. Colorectal Dis. 2010;12(10):958–64. doi:10.1111/j.1463-1318.2009.02006. PubMedCrossRef Shabbir J, Britton DC. Stoma complications: a literature overview. Colorectal Dis. 2010;12(10):958–64. doi:10.1111/j.1463-1318.2009.02006. PubMedCrossRef
5.
Zurück zum Zitat Rondelli F, Reboldi P, Rulli A, et al. Loop ileostomy versus loop colostomy for fecal diversion after colorectal or coloanal anastomosis: a meta-analysis. Int J Colorectal Dis. 2009;24(5):479–88. doi:10.1007/s00384-009-0662-x. PubMedCrossRef Rondelli F, Reboldi P, Rulli A, et al. Loop ileostomy versus loop colostomy for fecal diversion after colorectal or coloanal anastomosis: a meta-analysis. Int J Colorectal Dis. 2009;24(5):479–88. doi:10.1007/s00384-009-0662-x. PubMedCrossRef
6.
Zurück zum Zitat Güenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D. Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev. 2007;(1):CD004647. Güenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D. Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev. 2007;(1):CD004647.
7.
Zurück zum Zitat Edwards DP, Leppington-Clarke A, Sexton R, Heald RJ, Moran BJ. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial. Br J Surg. 2001;88(3):360–3. PubMedCrossRef Edwards DP, Leppington-Clarke A, Sexton R, Heald RJ, Moran BJ. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial. Br J Surg. 2001;88(3):360–3. PubMedCrossRef
8.
Zurück zum Zitat Gooszen AW, Geelkerken RH, Hermans J, et al. Quality of life with a temporary stoma: ileostomy vs. colostomy. Dis Colon Rectum. 2000;43:650. PubMedCrossRef Gooszen AW, Geelkerken RH, Hermans J, et al. Quality of life with a temporary stoma: ileostomy vs. colostomy. Dis Colon Rectum. 2000;43:650. PubMedCrossRef
9.
Zurück zum Zitat Tang CL, Seow-Choen F, Fook-Chong S, Eu KW. Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision: a prospective, randomized trial. Dis Colon Rectum. 2003;46(9):1200–7. PubMedCrossRef Tang CL, Seow-Choen F, Fook-Chong S, Eu KW. Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision: a prospective, randomized trial. Dis Colon Rectum. 2003;46(9):1200–7. PubMedCrossRef
10.
Zurück zum Zitat Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D. Morbidity of temporary loop ileostomy in patients with colorectal cancer. Dis Colon Rectum. 2006;49(7):1011–7. PubMedCrossRef Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D. Morbidity of temporary loop ileostomy in patients with colorectal cancer. Dis Colon Rectum. 2006;49(7):1011–7. PubMedCrossRef
11.
Zurück zum Zitat Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E. Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy. Br J Surg. 2008;95(6):693–8. doi:10.1002/bjs.6212. PubMedCrossRef Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E. Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy. Br J Surg. 2008;95(6):693–8. doi:10.1002/bjs.6212. PubMedCrossRef
12.
Zurück zum Zitat Omundsen M, Hayes J, Collinson R, et al. Early ileostomy closure: is there a downside? ANZ J Surg. 2012;82(5):352–4. doi:10.1111/j.1445-2197.2012.06033.x. PubMedCrossRef Omundsen M, Hayes J, Collinson R, et al. Early ileostomy closure: is there a downside? ANZ J Surg. 2012;82(5):352–4. doi:10.1111/j.1445-2197.2012.06033.x. PubMedCrossRef
13.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13. PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13. PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Pox C, Aretz S, Bischoff SC, et al. S3-guideline colorectal cancer version 1.0. Z Gastroenterol. 2013;51(8):753–854. doi:10.1055/s-0033-1350264. Article in German. PubMedCrossRef Pox C, Aretz S, Bischoff SC, et al. S3-guideline colorectal cancer version 1.0. Z Gastroenterol. 2013;51(8):753–854. doi:10.1055/s-0033-1350264. Article in German. PubMedCrossRef
15.
Zurück zum Zitat Jordi-Galais P, Turrin N, Tresallet C, et al. Early closure of temporary stoma of the small bowel. Gastroenterol Clin Biol. 2003;27(8–9):697–9. PubMed Jordi-Galais P, Turrin N, Tresallet C, et al. Early closure of temporary stoma of the small bowel. Gastroenterol Clin Biol. 2003;27(8–9):697–9. PubMed
16.
Zurück zum Zitat Menegaux F, Jordi-Galais P, Turrin N, Chigot JP. Closure of small bowel stomas on postoperative day 10. Eur J Surg. 2002;168(12):713–5. PubMedCrossRef Menegaux F, Jordi-Galais P, Turrin N, Chigot JP. Closure of small bowel stomas on postoperative day 10. Eur J Surg. 2002;168(12):713–5. PubMedCrossRef
17.
Zurück zum Zitat Bakx R, Busch OR, van Geldere D, et al. Feasibility of early closure of loop ileostomies: a pilot study. Dis Colon Rectum. 2003;46(12):1680–4. PubMedCrossRef Bakx R, Busch OR, van Geldere D, et al. Feasibility of early closure of loop ileostomies: a pilot study. Dis Colon Rectum. 2003;46(12):1680–4. PubMedCrossRef
18.
Zurück zum Zitat Hindenburg T, Rosenberg J. Closing a temporary ileostomy within two weeks. Dan Med Bull. 2010;57(6):A4157. PubMed Hindenburg T, Rosenberg J. Closing a temporary ileostomy within two weeks. Dan Med Bull. 2010;57(6):A4157. PubMed
19.
Zurück zum Zitat Mabrut JY, Favre JP, Desrousseaux B, et al. Safety and long-term outcome of a new concept for surgical adhesion-reduction strategies (Prevadh): a prospective, multicenter study. Hepatogastroenterology. 2008;55(82–83):517–21. PubMed Mabrut JY, Favre JP, Desrousseaux B, et al. Safety and long-term outcome of a new concept for surgical adhesion-reduction strategies (Prevadh): a prospective, multicenter study. Hepatogastroenterology. 2008;55(82–83):517–21. PubMed
20.
Zurück zum Zitat Memon S, Heriot AG, Atkin CE, Lynch AC. Facilitated early ileostomy closure after rectal cancer surgery: a case-matched study. Tech Coloproctol. 2012;16(4):285–90. doi:10.1007/s10151-012-0843-4. PubMedCrossRef Memon S, Heriot AG, Atkin CE, Lynch AC. Facilitated early ileostomy closure after rectal cancer surgery: a case-matched study. Tech Coloproctol. 2012;16(4):285–90. doi:10.1007/s10151-012-0843-4. PubMedCrossRef
21.
Zurück zum Zitat Ihedioha U, Muhtaseb S, Kalmar K, et al. A closure of loop ileostomies: is early discharge safe and achievable? Scott Med J. 2010;55(1):27–9. PubMedCrossRef Ihedioha U, Muhtaseb S, Kalmar K, et al. A closure of loop ileostomies: is early discharge safe and achievable? Scott Med J. 2010;55(1):27–9. PubMedCrossRef
22.
Zurück zum Zitat Gentilli S, Pizzorno C, Pessione S, et al. Early stoma closure in colorectal resections after endoscopic monitoring of the anastomosis. Clinical results. Chir Ital. 2007;59(4):507–12. Article in Italian. PubMed Gentilli S, Pizzorno C, Pessione S, et al. Early stoma closure in colorectal resections after endoscopic monitoring of the anastomosis. Clinical results. Chir Ital. 2007;59(4):507–12. Article in Italian. PubMed
23.
24.
Zurück zum Zitat Bhangu A, Futaba K, Patel A, Pinkney T, Morton D. Reinforcement of closure of stoma site using a biological mesh. Tech Coloproctol. 2014;18:305–8. Bhangu A, Futaba K, Patel A, Pinkney T, Morton D. Reinforcement of closure of stoma site using a biological mesh. Tech Coloproctol. 2014;18:305–8.
Metadaten
Titel
Early protective ileostomy closure following stoma formation with a dual-sided absorbable adhesive barrier
verfasst von
MD G. Köhler
MD Doz. Dr. G. Spaun
MD Dr. R.-R. Luketina
MD Dr. S. A. Antoniou
MD Doz. Dr. O. O. Koch
MD Prof. Dr. K. Emmanuel
Publikationsdatum
01.11.2014
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2014
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-014-0266-8