Annals of Coloproctology

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Technical Note

Technical tip

Endoscopic transstomal stent insertion: a novel approach for a stenosed stoma in a challenging patient: Feras Aljarad, Ashutosh Gumber, Anne Marie McLeary, Kawan Shalli; Ann Coloproctol. 2023;39(4):357-361. Published online February 9, 2023; DOI: https://doi.org/10.3393/ac.2022.00962.0137

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Transstomal stent deployment to maintain the patency of stoma in a challenging patient who developed stoma stenosis, is a minimal invasive, novel technique. This is a new and alternative approach in management of stoma stenosis in a difficult case using a biodegradable stent for end colostomy.

Citations

Citations to this article as recorded by

Application of a novel two-piece pouch in postoperative enterostomy in miniature Parma pigs
Yingjie Liu, Caiyan Xue, Jianyuan Wan, Meijiao Lin
Asian Journal of Surgery.2025; 48(3): 1866. CrossRef
The Stomal Stent: A Novel Bridging Therapy for Patients Requiring Delayed Ostomy Revision
Mason Henrich, Bianca Fischer, Jun Tashiro
The American Surgeon™.2025; 91(4): 653. CrossRef

Original Articles

Stoma

Protective loop ileostomy or colostomy? A risk evaluation of all common complications: Yi-Wen Yang, Sheng-Chieh Huang, Hou-Hsuan Cheng, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Chun-Chi Lin, Hung-Hsin Lin, Yuan-Tzu Lan; Ann Coloproctol. 2024;40(6):580-587. Published online January 27, 2023; DOI: https://doi.org/10.3393/ac.2022.00710.0101

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Abstract PDF

Purpose
Protective ileostomy and colostomy are performed in patients undergoing low anterior resection with a high leakage risk. We aimed to compare surgical, medical, and daily care complications between these 2 ostomies in order to make individual choice.
Methods
Patients who underwent low anterior resection for rectal tumors with protective stomas between January 2011 and September 2018 were enrolled. Stoma-related complications were prospectively recorded by wound, ostomy, and continence nurses. The cancer stage and treatment data were obtained from the Taiwan Cancer Database of our Big Data Center. Other demographic data were collected retrospectively from medical notes. The complications after stoma creation and after the stoma reversal were compared.
Results
There were 176 patients with protective colostomy and 234 with protective ileostomy. Protective ileostomy had higher proportions of high output from the stoma for 2 consecutive days than protective colostomy (11.1% vs. 0%, P<0.001). Protective colostomy resulted in more stoma retraction than protective ileostomy (21.6% vs. 9.4%, P=0.001). Female, open operation, ileostomy, and carrying stoma more than 4 months were also significantly associated with a higher risk of stoma-related complications during diversion. For stoma retraction, the multivariate analysis revealed that female (odds ratio [OR], 4.00; 95% confidence interval [CI], 2.13–7.69; P<0.001) and long diversion duration (≥4 months; OR, 2.33; 95% CI, 1.22–4.43; P=0.010) were independent risk factors, but ileostomy was an independent favorable factor (OR, 0.40; 95% CI, 0.22–0.72; P=0.003). The incidence of complication after stoma reversal did not differ between colostomy group and ileostomy group (24.3% vs. 20.9%, P=0.542).
Conclusion
We suggest avoiding colostomy in patients who are female and potential prolonged diversion when stoma retraction is a concern. Otherwise, ileostomy should be avoided for patients with impaired renal function. Wise selection and flexibility are more important than using one type of stoma routinely.

Citations

Citations to this article as recorded by

Gut microbiome and plasma metabolome alterations in ileostomy and after closure of ileostomy
Liang Xu, Xiaolong Li, Lang Chen, Haitao Ma, Ying Wang, Wenwen Liu, Anyan Liao, Liang Tan, Xiao Gao, Weidong Xiao, Hua Yang, Guangyan Ji, Yuan Qiu, Wei-Hua Chen, Qin Liu, Song Liu, Yang Yang
Microbiology Spectrum.2025;[Epub] CrossRef
Effect of one-stitch method of temporary ileostomy on the surgical outcomes and complications after laparoscopic low anterior resection in rectal cancer patients: a propensity score matching analysis
Xin-Peng Shu, Jia-Liang Wang, Zi-Wei Li, Fei Liu, Xu-Rui Liu, Lian-Shuo Li, Yue Tong, Xiao-Yu Liu, Chun-Yi Wang, Yong Cheng, Dong Peng
European Journal of Medical Research.2025;[Epub] CrossRef
The Differences in Postoperative Nursing Between Temporary Ileostomy and Temporary Colostomy: A Retrospective Cohort Study
Mei Wang, Lihong Dai, Xia Fang, Yan Zheng, Yuanhao Shen, Yang Yu
Nursing Open.2025;[Epub] CrossRef
Uso de ileostomía derivativa en cáncer de ovario. Revisión de la literatura
Franco Rafael Ruiz-Echeverría, Pedro Hernando Calderón-Quiroz, Juliana Rendón-Hernández
Revista Colombiana de Cirugía.2024;[Epub] CrossRef
Meta-analysis: loop ileostomy versus colostomy to prevent complications of anterior resection for rectal cancer
Shilai Yang, Gang Tang, Yudi Zhang, Zhengqiang Wei, Donglin Du
International Journal of Colorectal Disease.2024;[Epub] CrossRef
The Role of Colon in Isolated Intestinal Transplantation: Description of 4 Cases
Pierpaolo Di Cocco, Giulia Bencini, Alessandro Martinino, Egor Petrochenkov, Stepan Akshelyan, Kentaro Yoshikawa, Mario Spaggiari, Jorge Almario-Alvarez, Ivo Tzvetanov, Enrico Benedetti, Gaetano Gallo
International Journal of Surgical Oncology.2024;[Epub] CrossRef

Benign bowel disease

Short-term outcomes in patients undergoing laparoscopic surgery for deep infiltrative endometriosis with rectal involvement: a single-center experience of 168 cases: Sara Gortázar de las Casas, Emanuela Spagnolo, Salomone Di Saverio, Mario Álvarez-Gallego, Ana López Carrasco, María Carbonell López, Sergio Torres Cobos, Constantino Fondevila Campo, Alicia Hernández Gutiérrez, Isabel Pascual Miguelañez; Ann Coloproctol. 2023;39(3):216-222. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00829.0118

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Abstract PDF

Purpose
The surgical management of deep infiltrative endometriosis (DE) involving the rectum remains a challenge. The objective of this study was to assess the outcomes from a single tertiary center over a decade with an emphasis on the role of a protective loop ileostomy (PI).
Methods
A retrospective review of outcomes for 168 patients managed between 2008 and 2018 is presented including 57 rectal shaves, 23 discoid excisions, and 88 segmental rectal resections.
Results
The nodule size (mean±standard deviation) in the segmental resection group was 32.7±11.2 mm, 23.4±10.5 mm for discoid excision, and 18.8±6.0 mm for rectal shaves. A PI was performed in 19 elective cases (11.3%) usually for an ultra-low anastomosis <5 cm from the anal verge. All Clavien-Dindo grade III/IV complications occurred after segmental resections and included 5 anastomotic leaks, 6 rectovaginal fistulas, 2 ureteric fistulas, and 1 ureteric stenosis. Of 26 stomas (15.5%), there were 19 PIs, 3 secondary ileostomies (after complications), and 4 end colostomies. The median time to PI closure was 5.8 months (range, 0.4–16.7 months) in uncomplicated disease compared with 9.2 months (range, 4.7–18.4 months) when initial postoperative complications were recorded (P=0.019). Only 1 patient with a recurrent rectovaginal fistula had a permanent colostomy.
Conclusion
In patients with DE and rectal involvement a PI is selectively used for low anastomoses and complex pelvic reconstructions. Protective stomas and those used in the definitive management of a major postoperative complication can usually be reversed.

Citations

Citations to this article as recorded by

Surgeons' workload assessment during indocyanine-assisted deep endometriosis surgery using the surgery task load index: The impact of the learning curve
Emanuela Spagnolo, Ignacio Cristóbal Quevedo, Sara Gortázar de las Casas, Ana López Carrasco, Maria Carbonell López, Isabel Pascual Migueláñez, Alicia Hernández Gutiérrez
Frontiers in Surgery.2022;[Epub] CrossRef
Quality of Life in Women after Deep Endometriosis Surgery: Comparison with Spanish Standardized Values
Alicia Hernández, Elena Muñoz, David Ramiro-Cortijo, Emanuela Spagnolo, Ana Lopez, Angela Sanz, Cristina Redondo, Patricia Salas, Ignacio Cristobal
Journal of Clinical Medicine.2022; 11(20): 6192. CrossRef

Benign proctology,Rare disease & stoma,Surgical technique

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction: Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

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Graphical Abstract Abstract PDF

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Case Report

Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report: Young Sun Choi, Kil-young Lee, Youn Young Park, Hyung Jin Kim, Jaeim Lee; Ann Coloproctol. 2023;39(2):175-177. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.00185.0026

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Abstract PDF

Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.

Citations

Citations to this article as recorded by

Tumor Recurrence at the Colostomy Site: A Rare Case Report and Literature Review
Abdelhak Ettaoussi, Ilias El Azhari, Nassima Fakhiri, Abdessamad Majd, Kamal Khadija, Mounir Bouali, Abdelilah El Bakouri, Khalid Khaleq, Khalid El Hattabi
European Journal of Medical and Health Research.2025; 3(3): 215. CrossRef
Colostomy‐site carcinoma with primitive phenotype in a rectal cancer patient after achieving pathological complete response with neoadjuvant chemoradiotherapy
Takayuki Kodama, Maki Kanzawa, Hiroshi Hasegawa, Shuichi Tsukamoto, Mari Nishio, Manabu Shigeoka, Yu‐ichiro Koma, Tomoo Itoh, Hiroshi Yokozaki
Pathology International.2024; 74(1): 33. CrossRef
Metachronous Carcinoma at Colostomy Site Post Abdominoperineal Resection – A Rare Presentation Case Report
Muhammed Huzaifa, Ankita Singh, Vaibhav Aggarwal, Anita Dhar
Clinical Cancer Investigation Journal.2023; 12(2): 1. CrossRef
Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent
Kayleigh A M van Dam, Thaís T T Tweed, Bart de Vries, Henricus J Belgers
Journal of Surgical Case Reports.2023;[Epub] CrossRef

Original Articles

Benign diesease & IBD,Minimally invasive surgery

Laparoscopic Hartmann reversal: experiences from a developing country: Dung Anh Nguyen, Tuong-Anh Mai-Phan, Truc Thanh Thai, Hai Van Nguyen; Ann Coloproctol. 2022;38(4):297-300. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2020.00577.0082

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Abstract PDF

Purpose
Laparoscopic surgery is considered a promising approach for Hartmann reversal but is also a complicated major surgical procedure. We conducted a retrospective analysis at a city hospital in Vietnam to evaluate the treatment technique and outcomes of laparoscopic Hartmann reversal (LHR).
Methods
A colorectal surgery database in 5 years between 2015 and 2019 (1,175 cases in total) was retrieved to collect 35 consecutive patients undergoing LHR.
Results
The patients had a median age of 61 years old. The median operative time was 185 minutes. All the procedures were first attempted laparoscopically with a conversion rate of 20.0% (7 of 35 cases). There was no intraoperative complication. Postoperative mortality and morbidity were 0 and 11.4% (2 medical, 1 deep surgical site infection, and 1 anastomotic leak required reoperation) respectively. The median time to first bowel activity was 2.8 days and median length of hospital stay was 8 days.
Conclusion
When performed by skilled surgeons, LHR is a feasible and safe operation with acceptable morbidity rate.

Citations

Citations to this article as recorded by

Surgical Outcomes of Open and Laparoscopic Hartmann Reversal: A Single-Center Comparative Study
Mu-Han Tsai, Ming-Jenn Chen, Khaa-Hoo Ong, Chih-Ying Lu, Chung-Han Ho, Hsuan-Yi Huang, Yu-Feng Tian, I-Ning Yang
Cureus.2024;[Epub] CrossRef

Efficacy and Safety of Laparoscopic Hartmann Colostomy Reversal: Won Park, Won Cheol Park, Keun Young Kim, Seok Youn Lee; Ann Coloproctol. 2018;34(6):306-311. Published online December 20, 2018; DOI: https://doi.org/10.3393/ac.2018.09.07

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Abstract PDF

Purpose
Hartmann operation is widely recognized as a useful procedure, especially in emergencies involving the rectosigmoid colon. One of the surgeon’s foremost concerns after Hartmann operation is future colostomy reversal, as colostomy reversal after a Hartmann procedure is associated with relatively high morbidity and mortality. Laparoscopic surgical techniques continue to prove useful for an ever-increasing variety of indications. We analyzed the outcomes of laparoscopic Hartmann colostomy reversals at our center.
Methods
We retrospectively analyzed the hospital records of 170 patients who had undergone Hartmann operation between January 2010 and June 2017 at Wonkwang University Hospital. Among 68 Hartmann colostomy reversals, we evaluated and compared the outcomes of 3 groups of patients: 29 patients in the open colostomy reversal group (OG) who had undergone laparotomies for Hartmann reversals, 19 patients in the conversion group (CG) whose laparoscopic procedures had required conversion to a laparotomy, and 20 patients in the laparoscopy group (LG).
Results
The overall reversal rate for Hartmann colostomies was 40.5% during this time period. The duration of hospital stay was significantly shorter among LG patients (10.15 ± 2.94 days) than among OG patients (16 ± 9.5 days). The overall complication rate among OG patients was higher than that among LG patients (adjusted odds ratio, 8.78; P = 0.01). The most common complication was postoperative ileus (19.1%).
Conclusion
If no contraindications to laparoscopy exist, surgeons should favor a laparoscopic reversal of Hartmann operation over an open reversal.

Citations

Citations to this article as recorded by

Complete prevention of anastomotic leakage using total enteric flow diversion
Tao Hu, Jing Wang, Nan-Hui Yu
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Surgical Outcomes of Open and Laparoscopic Hartmann Reversal: A Single-Center Comparative Study
Mu-Han Tsai, Ming-Jenn Chen, Khaa-Hoo Ong, Chih-Ying Lu, Chung-Han Ho, Hsuan-Yi Huang, Yu-Feng Tian, I-Ning Yang
Cureus.2024;[Epub] CrossRef
Laparoscopic versus open Hartmann reversal: a propensity score matching analysis
Li Tan, Xiao-Yu Liu, Bin Zhang, Lian-Lian Wang, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single‐center retrospective study in Japan
Aya Sato, Ken Imaizumi, Hiroyuki Kasajima, Keisuke Obuchi, Kentaro Sato, Daisuke Yamana, Yosuke Tsuruga, Minoru Umehara, Michihiro Kurushima, Kazuaki Nakanishi
Asian Journal of Endoscopic Surgery.2022; 15(1): 137. CrossRef
A Case of Laparoscopic Hartmann's Procedure Followed by Laparoscopic Reversal for Perforated Diverticulitis
Ryo Maemoto, Shingo Tsujinaka, Ryotaro Sakio, Nao Kakizawa, Rei Takahashi, Yuuri Hatsuzawa, Yasuaki Kimura, Erika Machida, Sawako Tamaki, Hideki Ishikawa, Yasuyuki Miyakura, Toshiki Rikiyama
Nippon Daicho Komonbyo Gakkai Zasshi.2022; 75(1): 36. CrossRef
Is laparoscopy a reliable alternative to laparotomy in Hartmann's reversal? An updated meta-analysis
D. Chavrier, A. Alves, B. Menahem
Techniques in Coloproctology.2022; 26(4): 239. CrossRef
Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients
Anwar Medellin Abueta, Nairo Javier Senejoa, Mauricio Pedraza Ciro, Lina Fory, Carlos Perez Rivera, Carlos Edmundo Martinez Jaramillo, Lina Maria Mateus Barbosa, Heinz Orlando Ibañez Varela, Javier A. Carrera, Rafael Garcia Duperly, Luis A Sanchez, Ivan D
Health Science Reports.2022;[Epub] CrossRef
Laparoscopic Hartmann reversal: experiences from a developing country
Dung Anh Nguyen, Tuong-Anh Mai-Phan, Truc Thanh Thai, Hai Van Nguyen
Annals of Coloproctology.2022; 38(4): 297. CrossRef
Open versus laparoscopic Hartmann’s procedure: a systematic review and meta-analysis
Yingjia Zhang, Chunxi Liu, Kameswara Rishi Yeshayahu Nistala, Choon Seng Chong
International Journal of Colorectal Disease.2022; 37(12): 2421. CrossRef
Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study
Paolo Panaccio, Tommaso Grottola, Rossana Percario, Federico Selvaggi, Severino Cericola, Alfonso Lapergola, Maira Farrukh, Giuseppe Di Martino, Marco Ricciardiello, Pierluigi Di Sebastiano, Fabio Francesco Di Mola, Todd Pesavento
Surgery Research and Practice.2021; 2021: 1. CrossRef
Effects of Laparoscopic Hartmann Reversal on Short-term Operative Outcomes Among Vietnamese Patients
Viet Van Ung, Bang Cong Huynh, Vinh Chi Le, Dang Ngoc Tran, Trung Nguyen Vo, Tan Van Pham, Bac Hoang Nguyen
Journal of Coloproctology.2021; 41(02): 117. CrossRef
A comparative study between open versus laparoscopic Hartmann reversal
Hye Jung Cho, Woo Ram Kim, Jong Woo Kim
Medicine.2021; 100(47): e27976. CrossRef
Colorectal reconstructions following Hartmann’s procedure: challenges and solutions
A. N. Igolkin, V. V. Polovinkin
Innovative medicine of Kuban.2020; (4): 51. CrossRef
Emergency Hartmann’s Procedure and its Reversal: A Totally Laparoscopic 2-Step Surgery for the Treatment of Hinchey III and IV Diverticulitis
Diletta Cassini, Michelangelo Miccini, Farshad Manoochehri, Matteo Gregori, Gianandrea Baldazzi
Surgical Innovation.2019; 26(6): 770. CrossRef

Postoperative Outcomes of Stoma Takedown: Results of Long-term Follow-up: Bomina Paik, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee; Ann Coloproctol. 2018;34(5):266-270. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2017.12.13

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Abstract PDF

Purpose
Stoma takedown is a frequently performed procedure with considerable postoperative morbidities. Various skin closure techniques have been introduced to reduce surgical site infections. The aim of this study was to assess postoperative outcomes after stoma takedown during a long-term follow-up period.
Methods
Between October 2006 and December 2015, 84 consecutive patients underwent a colostomy or ileostomy takedown at our institution. Baseline characteristics and perioperative outcomes were analyzed through retrospective reviews of medical records.
Results
The proportion of male patients was 60.7%, and the mean age of the patients was 59.0 years. The overall complication rate was 28.6%, with the most common complication being prolonged ileus, followed by incisional hernia, anastomotic leakage, surgical site infection, anastomotic stenosis, and entero-cutaneous fistula. The mean follow-up period was 64.3 months. The univariate analysis revealed no risk factors related to overall complications or prolonged ileus.
Conclusion
The postoperative clinical course and long-term outcomes following stoma takedown were acceptable. Stoma takedown is a procedure that can be performed safely.

Citations

Citations to this article as recorded by

Complicated diverticulitis: Diagnostic precision and surgical solutions in a patient with chronic kidney disease
Sharon L. Hsieh, Nathaniel Grabill, Mena Louis, Bradley Kuhn
Radiology Case Reports.2025; 20(1): 346. CrossRef
Comparing Surgical Site Infection Rate Between Primary Closure and Rhomboid Flap After Stoma Reversal
Che-Ming Chu, Chih-Cheng Chen, Yu-Yao Chang, Kai-Jyun Syu, Shih-Lung Lin
Annals of Plastic Surgery.2024; 92(1S): S33. CrossRef
TIMING OF THE STOMA REVERSAL, WHAT IS THE SAFE PERIOD?: A RETROSPECTIVE OBSERVATIONAL STUDY
GIRIDHAR ASHWATH, ESHWAR KATHIRESAN MANASIJAN, ANTHONY P ROZARIO
Asian Journal of Pharmaceutical and Clinical Research.2024; : 181. CrossRef
Diverting ileostomy in benign colorectal surgery: the real clinical cost analysis
F. Ascari, G. Barugola, G. Ruffo
Updates in Surgery.2024; 76(5): 1761. CrossRef
Laparoscopic versus open Hartmann reversal: a propensity score matching analysis
Li Tan, Xiao-Yu Liu, Bin Zhang, Lian-Lian Wang, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Defunctioning stoma in anterior resection for rectal cancer does not impact anastomotic leakage: a national population-based cohort study
Eihab Munshi, Marie-Louise Lydrup, Pamela Buchwald
BMC Surgery.2023;[Epub] CrossRef
Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure
Muhammad Awais Khan, Khurram Niaz, Shahzeb Asghar, Maaz A Yusufi, Mohtamam Nazir, Syed Muhammad Ali, Aryan Ahmed, Akeel Ahamed Salahudeen, Talha Kareem
Cureus.2023;[Epub] CrossRef
Factors Predicting the Reversal of Hartmann’s Procedure
Ömer Yalkın, Fatih Altıntoprak, Mustafa Yener Uzunoğlu, Yasin Alper Yıldız, Muhammet Burak Kamburoğlu, Necattin Fırat, Fehmi Çelebi, Mihajlo Jakovljevic
BioMed Research International.2022;[Epub] CrossRef

Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery: Seung-Seop Yeom, Chan Wook Kim, Sung Woo Jung, Se Heon Oh, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2018;34(2):72-77. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.29

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Abstract PDF

Purpose
Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique.
Methods
We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation.
Results
One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001).
Conclusion
The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery.

Citations

Citations to this article as recorded by

Non-operative management of gallstone sigmoid ileus in a patient with a prostatic cancer
Ahmed M AlMuhsin, Abdulaziz Bazuhair, Omar AlKhlaiwy, Rami O Abu Hajar, Thabit Alotaibi
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction
Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Annals of Coloproctology.2022; 38(4): 319. CrossRef
Minimally invasive colostomy with endoscopy as a novel technique for creation of a trephine stoma
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Yutaka Suzuki
Scientific Reports.2021;[Epub] CrossRef

Case Report

Side-to-Side Ileosigmoidostomy Shunting Surgery for the Treatment of Elderly Patients With Chronic Constipation: Yuda Handaya, Agung Maryanto, Marijata; Ann Coloproctol. 2017;33(6):249-252. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.249

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Abstract PDF: Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic constipation (slow transit constipation) and treated with conventional therapy, but did not improve. For that reason, side-to-side ileosigmoidostomy shunting surgery was performed. After the surgery, the average time until normal defecation was 16 days, and the defecation frequency was 3 to 4 times a day with no need for a laxative. No patient had a recurrence of constipation. Based on these results, side-to-side ileosigmoidostomy shunting surgery is expected to restore digestive function and can be considered as an alternative therapy for elderly patients with chronic constipation.

Original Articles

Feasibility of Neurovascular Antropylorus Perineal Transposition With Pudendal Nerve Anastomosis Following Anorectal Excision: A Cadaveric Study for Neoanal Reconstruction: Abhijit Chandra, Ashok Kumar, M Noushif, Nitish Gupta, Vijay Kumar, Navneet Kumar Chauhan, Vishal Gupta; Ann Coloproctol. 2013;29(1):7-11. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.7

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Abstract PDF

Purpose

Perineal transposition of the antropyloric valve following an anorectal excision as a substitute for a permanent colostomy has recently been reported in humans. However, the problem of neural control still remains in these patients. Our aim herein was to study the anatomical feasibility of an anastomosis between the pudendal nerve branches (inferior rectal nerve) innervating the external anal sphincter and the anterior vagal branches of the perineally-transposed antropyloric segment in cadavers.

Methods

The antropyloric segment, along with its carefully dissected branch of the anterior vagus, was mobilized based on the left gastroepiploic pedicle in six fresh human cadavers. The antropyloric valve was then transposed in the perineum after the pudendal nerve branches had been dissected out, and an approximation of these two nerves was performed to ascertain the technical feasibility of their neural anastomosis.

Results

The anterior vagus innervating the antropylorus could be harvested in all cadavers below the hepatic division of the main vagus trunk. The inferior rectal nerve or its branches were found consistently around the 3 or the 9 o'clock position in the ischioanal fossa. An anatomical tension-free approximation of the anterior vagus branch (of the transposed antropyloric segment) to the inferior rectal nerve in the perineum was feasible in all the cadavers studied.

Conclusion

An inferior rectal nerve anastomosis with the anterior vagal branch of the perineally-transposed antropyloric segment can be achieved anatomically. This preliminary step can be the basis for future animal studies and subsequent clinical application of the procedure for possible neural control of the transposed antropyloric segment in the perineum.

Citations

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Current surgical strategies to treat fecal incontinence
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Dynamic Article
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Neuromodulation of perineally transposed antropylorus with pudendal nerve anastomosis following total anorectal reconstruction in humans
Abhijit Chandra, Hardeep S. Malhotra, Noushif M, Vishal Gupta, Sunil K. Singh, Neeraj Kumar, Rakesh S. Lalla, Ayush Chandra, Ravindra K. Garg
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Incidence and Risk Factors of Parastomal Hernia: Yeun Ju Sohn, Sun Mi Moon, Ui Sup Shin, Sun Hee Jee; J Korean Soc Coloproctol. 2012;28(5):241-246. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.241

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Abstract PDF

Purpose

Among the various stoma complications, the parastomal hernia (PSH) is the most common. Prevention of PSH is very important to improve the quality of life and to prevent further serious complications. The aim of this study was to analyze the incidence and the risk factors of PSH.

Methods

From January 2002 and October 2008, we retrospectively reviewed 165 patients who underwent an end colostomy. As a routine oncologic follow-up, abdomino-pelvic computed tomography was used to examine the occurrence of the PSH. The associations of age, sex, body mass index (BMI), history of steroid use and comorbidities to the development of the PSH were analyzed. The median duration of the follow-up was 36 months (0 to 99 months).

Results

During follow-up, 50 patients developed a PSH and the 5-year cumulative incidence rate of a PSH, obtained by using the Kaplan-Meier method, was 37.8%. In the multivariate COX analysis, female gender (hazard ratio [HR], 3.29; 95% confidence interval [CI], 1.77 to 6.11; P < 0.0001), age over 60 years (HR, 2.37; 95% CI, 1.26 to 4.46; P = 0.01), BMI more than 25 kg/m² (HR, 1.8; 95% CI, 1.02 to 3.16; P = 0.04), and hypertension (HR, 2.08; 95% CI, 1.14 to 3.81; P = 0.02) were all independent risk factors for the development of a PSH.

Conclusion

The 5-year incidence rate of a PSH was 37.8%. The significant risk factors of a PSH were as follows: female gender, age over 60 years, BMI more than 25 kg/m², and hypertension. Using a prophylactic mesh during colostomy formation might be advisable when the patients have these factors.

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Review

Management of Colorectal Trauma: Won Jun Choi; J Korean Soc Coloproctol. 2011;27(4):166-172. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.166

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Abstract PDF

Although the treatment strategy for colorectal trauma has advanced during the last part of the twentieth century and the result has improved, compared to other injuries, problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue. For that reason, we designed this article to address current recommendations for management of colorectal injuries based on a review of literature. According to the reviewed data, although sufficient evidence exists for primary repair being the treatment of choice in most cases of nondestructive colon injuries, many surgeons are still concerned about anastomotic leakage or failure, and prefer to perform a diverting colostomy. Recently, some reports have shown that primary repair or resection and anastomosis, is better than a diverting colostomy even in cases of destructive colon injuries, but it has not fully established as the standard treatment. The same guideline as that for colonic injury is applied in cases of intraperitoneal rectal injuries, and, diversion, primary repair, and presacral drainage are regarded as the standards for the management of extraperitoneal rectal injuries. However, some reports state that primary repair without a diverting colostomy has benefit in the treatment of extraperitoneal rectal injury, and presacral drainage is still controversial. In conclusion, ideally an individual management strategy would be developed for each patient suffering from colorectal injury. To do this, an evidence-based treatment plan should be carefully developed.

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Case Report

Primary Repair of a Huge Incisional Hernia by Using an External Oblique Myofascial Releasing Technique without Mesh: A Case Report.: Park, Ki Jae , Woo, Jin Hee , Lee, Hak Youn , Lee, Se Yong , Shin, Jong Sok , Roh, Young Hoon , Kim, Sung Heun , Choi, Hong Jo; J Korean Soc Coloproctol. 2008;24(5):386-389.; DOI: https://doi.org/10.3393/jksc.2008.24.5.386

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Abstract PDF: Incisional hernias are one of the most common complications after abdominal surgery and are an important cause of postoperative morbidity. Various methods are available for repairing incisional hernias, such as primary suture repair, an open mesh technique, and a laparoscopic mesh technique. The surgical management of a large incisional hernia by using a prosthetic mesh in a contaminated operative field (i.e., opened bowel from previous stoma or bowel resection) remains a difficult challenge because the non-absorbable mesh used is accompanied by a potential risk of infection and its related morbidity. We present a case of a large abdominal-wall defect, which was corrected by utilizing an external oblique myofascial releasing technique without the use of mesh, in a patient with an incisional hernia coexistent with Hartmann's colostomy.

Original Article

The Complications of Stoma Take-down.: Kim, Dae Dong , Kim, Eun Jung , Lee, Hae Ok , Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(2):83-90.; DOI: https://doi.org/10.3393/jksc.2008.24.2.83

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Abstract PDF

PURPOSE
The study aimed to investigate the complications accompanying stoma take-down and to elucidate the significant factors associated with complications. METHODS: We recruited 341 patients who underwent stoma take-down in our hospital between January 2000 and December 2005. Data on various complications during this procedure, i.e., wound infection, prolonged ileus, and anastomotic leakage, were collected with respect to patient- and operation-associated parameters. RESULTS: Complications of stoma take-down developed in 72 (21.1%) patients: 53 (20.3%) patients in a loop ileosotmy, 10 (21.3%) patients in a loop colostomy, and 9 (27.3%) patients in a Hartmann colostomy, The overall complication rate was significantly associated with the urgency of the primary operation (elective vs. emergent, 17.8% vs. 29%, P=0.017), and with the operation time (< or =80 min vs. > 80 min, 16.5% vs. 29.3%, P=0.005). Among the complications, ileus developed in 46 (13.5%) patients, wound infection in 17 (5.0%) patients, and anastomotic leakage in 5 (1.5%) patients. Wound infection was related to the type of stoma between a loop ileostomy and a Hartmann colostomy (3.5% vs. 12.1%; P=0.014), but no other factors were associated with other complications. CONCLUSIONS: There were significant differences in overall complications in relation to urgency of the primary operation and the operation time, but there was no statistical difference in complications between a loop ileostomy and a loop colostomy take- down groups. The significance of these factors appears to be reduced with accurate surgical technique and patient care.

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