Annals of Coloproctology

Display

Sort by :

Review

Stoma

Comparison of purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies: Filippo Carannante, Guglielmo Niccolò Piozzi, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Vincenzo Schiavone, Jim S. Khan, Marco Caricato, Gabriella Teresa Capolupo; Ann Coloproctol. 2025;41(6):491-500. Published online December 31, 2025; DOI: https://doi.org/10.3393/ac.2025.00801.0114

482 View
30 Download

Abstract PDF: Purpose
Stoma reversal is associated with notable postoperative morbidity. Several techniques exist for skin closure after stoma reversal, with linear primary closure (LC) and purse-string closure (PS) being the most common. This systematic review and meta-analysis aim to compare LC and PS skin closure after stoma reversal in terms of surgical site infection (SSI) rates, wound healing, and cosmesis.
Methods
In accordance with the PRISMA statement, a systematic review of skin closure after stoma reversal was conducted using MEDLINE (PubMed), Embase, Web of Science, and Scopus.
Results
Eleven studies, enrolling 1,052 patients (PS, n=534; LC, n=518), published between 2006 and 2024, were included. The overall quality of the studies was considered acceptable, with a mean Jadad scale score of 4 (range, 3–5). Patients underwent ileostomy or ileostomy/colostomy in 6 and 5 studies, respectively. No differences were observed between groups in operative time, length of hospital stay, intestinal obstruction, or incisional hernia. However, SSI and overall infection rates were higher in the LC group, with a statistically significant difference for SSI.
Conclusion
Skin closure following stoma reversal using the PS technique may offer advantages over LC. PS is associated with significantly lower SSI rates compared to LC. Although a large randomized controlled trial with long-term follow-up is still required, current findings suggest that PS could be considered the standard of care for wound closure after ileostomy reversal.

Original Articles

ERAS

Clinical impact of a multimodal pain management protocol for loop ileostomy reversal: Jeong Sub Kim, Chul Seung Lee, Jung Hoon Bae, Seung Rim Han, Do Sang Lee, In Kyu Lee, Yoon Suk Lee, In Kyeong Kim; Ann Coloproctol. 2024;40(3):210-216. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2022.01137.0162

6,271 View
242 Download
3 Web of Science
4 Citations

Graphical Abstract Abstract PDF

Purpose
As introduced, multimodal pain management bundle for ileostomy reversal may be considered to reduce postoperative pain and hospital stay. The aim of this study was to evaluate clinical efficacy of perioperative multimodal pain bundle for ileostomy.
Methods
Medical records of patients who underwent ileostomy reversal after rectal cancer surgery from April 2017 to March 2020 were analyzed. Sixty-seven patients received multimodal pain bundle protocol with ileostomy reversal (group A) and 41 patients underwent closure of ileostomy with conventional pain management (group B).
Results
Baseline characteristics, including age, sex, body mass index, American Society of Anesthesiologists classification, diabetes mellitus, and smoking history, were not significantly different between the groups. The pain score on postoperative day 1 was significant lower in group A (visual analog scale, 2.6 ± 1.3 vs. 3.2 ± 1.2; P = 0.013). Overall consumption of opioid in group A was significant less than group B (9.7 ± 9.5 vs. 21.2 ± 8.8, P < 0.001). Hospital stay was significantly shorter in group A (2.3 ± 1.5 days vs. 4.1 ± 1.5 days, P < 0.001). There were no significant differences between the groups in postoperative complication rate.
Conclusion
Multimodal pain protocol for ileostomy reversal could reduce postoperative pain, usage of opioid and hospital stay compared to conventional pain management.

Citations

Citations to this article as recorded by

Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Multimodal analgesia for postoperative pain: pursuing liberation from pain, not redemption
Soo Yeun Park
Annals of Coloproctology.2024; 40(3): 189. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Optimizing postoperative pain management in minimally invasive colorectal surgery
Soo Young Lee
Annals of Coloproctology.2024; 40(6): 525. CrossRef

Benign bowel disease

Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review: Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee; Ann Coloproctol. 2024;40(5):424-430. Published online March 2, 2023; DOI: https://doi.org/10.3393/ac.2022.00976.0139

8,035 View
133 Download

Abstract PDF Supplementary Material: Purpose
Ileostomy volvulus is a rare cause of small bowel obstruction. We present an unusual case of ileostomy volvulus without the presence of adhesions. Additionally, a systematic literature review was performed to collate the current literature on the causes, diagnosis, treatment, and preventative measures of ileostomy-related small bowel obstruction.
Methods
PubMed (MEDLINE), Embase, Google Scholar, Scopus, and CENTRAL were searched from their inception up to August 2022. This study adhered to the PRISMA guidelines and was registered on PROSPERO. The primary outcomes included patients’ demographics, imaging modality, indication for initial surgery, type and configuration of stoma, surgical treatment, and recurrence of volvulus. The quality of included studies was assessed using the Murad tool. Written informed consent was obtained from the patient.
Results
Seven studies were included, comprising 967 patients. Stoma outlet obstruction (SOO) was reported in all 159 patients, and 12 had ileostomy volvulus as the cause. A majority of patients had loop ostomies for ileostomy volvulus. No complications or mortality were reported in the included studies, and half of the included studies were deemed to be of good quality.
Conclusion
This case demonstrates the need for high clinical suspicion of SOO in patients with loop ileostomy, and rapid management should be undertaken. Whilst loop ileostomies, increased rectus abdominal muscle thickness, and lower preoperative total glucocorticoid dosage are associated with SOO, large-scale retrospective studies are needed to validate our findings.

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

10,034 View
284 Download
5 Web of Science
8 Citations

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

The prognostic nutritional index and a multifactorial nomogram for predicting early stoma-related complications after prophylactic ileostomy: A retrospective cohort study
Xiao Lin, Yafei Zhang, Yuqin Wang, Wenjing Yan, Jing Bian, Xinrong Pei, Yan Zhang, Xia Sun
European Journal of Oncology Nursing.2026; 80: 103086. CrossRef
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
Preventive intestinal stoma: ileostomy, colostomy. Which option is safer? (meta-analysis and systematic review)
Yu. A. Elfimova, R. I. Fayzulin, S. V. Chernyshov, E. G. Rybakov
Koloproktologia.2025; 24(4): 152. 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

6,444 View
165 Download
3 Web of Science
2 Citations

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

13,203 View
277 Download
3 Web of Science
4 Citations

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

Transverse blowhole colostomy versus Hartmann’s for urgent management of large bowel obstruction secondary to diverticular stricture
Hannah R. Liefeld, Kristen L. Coleman, Kelsey Lawrence, James W. Ogilvie
International Journal of Colorectal Disease.2026;[Epub] CrossRef
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

Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries: Dan Assaf, David Hazzan, Almog Ben-Yaacov, Shachar Laks, Douglas Zippel, Lior Segev; Ann Coloproctol. 2023;39(2):168-174. Published online August 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00241.0034

9,638 View
263 Download
6 Web of Science
10 Citations

Abstract PDF

Purpose
One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS.
Methods
We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group.
Results
A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001).
Conclusion
Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.

Citations

Citations to this article as recorded by

High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
Atrial Flutter With Intraventricular Conduction Delay, Hypotension, and Bradycardia in the Setting of High-Output Ileostomy With Renal Failure, Hyperkalemia, and Metabolic Acidosis: A Case Report With Brief Literature Review
Edinen Asuka, Barbara Odac, Andrew Ndakotsu, Anastasia Postoev
Cureus.2025;[Epub] CrossRef
Preoperative High Agatston Score in Aorta Leads to Postoperative High-Output Ileostomy
Yusuke Kono, Manabu Yamamoto, Chiharu Yasui, Ryo Ishiguro, Takuki Yagyu, Kyoichi Kihara, Tomoyuki Matsunaga, Shuichi Takano, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshiyuki Fujiwara
Journal of Surgical Research.2025; 314: 139. CrossRef
A review of chyme reinfusion: new tech solutions for age old problems
Chen Liu, Sameer Bhat, Ian Bissett, Gregory O'Grady
Journal of the Royal Society of New Zealand.2024; 54(2): 161. CrossRef
Knowledge, attitudes, practices and associated factors regarding high output stoma of ileostomy among colorectal surgical nurses: a multicentre cross-sectional study
Qing Zhang, Jianan Sun, Dongxue Wang, Quan Wang, Haiyan Hu
Supportive Care in Cancer.2024;[Epub] CrossRef
Morphological predictors of water-electrolyte disorders in patients with preventive ileostomy after rectal resection for cancer
A.I. Maksimkin, Z.A. Bagatelia, V.M. Kulushev, E.N. Gordienko, M.S. Lebedko, S.S. Anikina, E.P. Shin
Pirogov Russian Journal of Surgery.2024; (4): 16. CrossRef
The Frequency of Stoma-Related Readmissions After Emergency and Elective Ileostomy Formation: The Leicester Experience
Ting-Wei Wu, Wen Yuan Chung, Hui En Jewel Ng, Ashley Yap, Konstantinos Baronos, Deepak Paul, Christopher P Neal, David Bowrey
Cureus.2024;[Epub] CrossRef
Predictors of High-output Stoma in Diverting Ileostomy for Rectal Cancer Surgery
Hiroaki Uehara, Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Yuya Enoki
Nippon Daicho Komonbyo Gakkai Zasshi.2023; 76(3): 286. CrossRef
Morpho-functional aspects of various parts of the intestine and risk factors associated with the preventive ileostomy (review)
A. I. Maksimkin, Z. A. Bagatelia, E. N. Gordienko, E. B. Emelyanova, D. M. Sakaeva
Koloproktologia.2023; 22(4): 147. CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Benign GI diease,Benign diesease & IBD,Rare disease & stoma

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons: David A. Clark, Bree Stephensen, Aleksandra Edmundson, Daniel Steffens, Michael Solomon; Ann Coloproctol. 2021;37(5):337-345. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.14.1

4,735 View
72 Download
8 Web of Science
9 Citations

Abstract PDF

Purpose
Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.
Methods
A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons on September 20, 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in 12 months, along with the surgeon’s preference for the use of diverting stomas, rectal tubes, and pelvic drains.
Results
There were 90 respondents to the survey (31.6%). Surgeons in Western Australia (71.4%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14.3%). South Australian surgeons are more likely to employ a mandatory TDI (100%) for ileal pouches than Queensland surgeons (42.9%). Rectal tubes are not commonly utilized (40.0% never use them), and pelvic drains are (45.6% in all cases). Surgeons consider a median AL rate of 15% was felt to justify the use of a TDI in low pelvic anastomoses and a median AL rate of 10% for ileal pouches
Conclusion
There is considerable geographical variation in colorectal surgical practice throughout Australia and New Zealand. While surgeons interrogate the same literature, there are presumably other factors that see translation into variations in clinical practice.

Citations

Citations to this article as recorded by

Predictors of pouch failure and quality of life following ileal pouch‐anal anastomosis for ulcerative colitis: a retrospective multicenter study
Ahmet Rencuzogullari, Cihangir Akyol, Ismail Hamzaoglu, Tahsin Colak, Tayfun Karahasanoglu, Ugur Sungurtekin, Sezai Leventoglu, Ersin Ozturk, Mustafa Ali Korkut, Selman Sokmen
ANZ Journal of Surgery.2025; 95(3): 457. CrossRef
Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study
David A. Clark, Karen Dobeli, Darren Allen, Brett McWhinney, Michael Lonne, Aleksandra Edmundson
Colorectal Disease.2025;[Epub] CrossRef
Feasibility of triple assessment of the anastomosis using an anastomotic checklist
Madeleine Louise Kelly, Amy Cao, Ruben Rajan, David A Clark
ANZ Journal of Surgery.2024; 94(10): 1812. CrossRef
Drain fluid amylase as a biomarker for the detection of anastomotic leakage after rectal resection without a diverting ileostomy
David A. Clark, Aleksandra Edmundson, Daniel Steffens, Craig Harris, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 813. CrossRef
Surgical management and long‐term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy
Tony McGiffin, David A. Clark, Aleks Edmundson, Daniel Steffens, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 806. CrossRef
Does an ileostomy cover the surgeon or the anastomosis?
David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
ANZ Journal of Surgery.2022; 92(1-2): 19. CrossRef
Risk taking propensity: Nurse, surgeon and patient preferences for diverting ileostomy
Ian Mackay, David A. Clark, James Nicholson, Aleks Edmundson, Daniel Steffens, Michael Solomon
Colorectal Disease.2022; 24(9): 1073. CrossRef
Multicenter Study of Drain Fluid Amylase as a Biomarker for the Detection of Anastomotic Leakage After Ileal Pouch Surgery Without a Diverting Ileostomy
David A. Clark, • Aleksandra Edmundson, Daniel Steffens, Graham Radford-Smith, Michael Solomon
Diseases of the Colon & Rectum.2022; 65(11): 1335. CrossRef
An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: Not yet ready to translate research studies into clinical practice
David A. Clark, Daniel Steffens, Michael Solomon
Colorectal Disease.2021; 23(11): 2795. CrossRef

Malignant disease, Functional outcomes,Colorectal cancer

The Relationship Between High-Output Stomas, Postoperative Ileus, and Readmission After Rectal Cancer Surgery With Diverting Ileostomy: Naa Lee, Soo Young Lee, Chang Hyun Kim, Han Deok Kwak, Jae Kyun Ju, Hyeong Rok Kim; Ann Coloproctol. 2021;37(1):44-50. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.03

5,678 View
171 Download
12 Web of Science
10 Citations

Abstract PDF

Purpose
This study aimed to evaluate the relationship between high-output stomas (HOSs), postoperative ileus (POI), and readmission after rectal cancer surgery with diverting ileostomy.
Methods
We included 302 patients with rectal cancer who underwent restorative resection with diverting ileostomy between January 2011 and December 2015. HOSs were defined as stomas with ≥ 2,000 mL/day output. We analyzed predictive factors for readmission of these patients.
Results
Forty-eight patients (15.9%) had HOSs during the hospital stay, and 41 patients (13.6%) experienced POI. HOSs were strongly associated with POI (45.8% vs. 7.5%, P < 0.001). The all-cause readmission rate was 16.9%, with 19 (6.3%) and 20 (6.6%) experiencing ileus and acute kidney injury, respectively. HOSs (27.1% vs. 15.0%, P = 0.040) and POI (34.1% vs. 14.2%, P = 0.002) were associated with all-cause readmission, and POI was associated with readmission with ileus (17.1% vs. 4.6%, P = 0.007). POI was an independent risk factor for all-cause readmission (adjusted odds ratio [OR], 2.640; 95% confidence interval [CI], 1.162 to 6.001; P = 0.020) and readmission with ileus (adjusted OR = 3.869; 95% CI 1.387 to 10.792; P = 0.010).
Conclusion
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.

Citations

Citations to this article as recorded by

High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
Summary of Best Evidence for the Dietary Management in Patients with High-Output Ileostomy
Ying Wang, Hua Peng, Cui Cui, Qi Zou, Mudi Yang
Journal of Multidisciplinary Healthcare.2025; Volume 18: 877. CrossRef
Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery
Sung Uk Bae
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Maximizing Readmission Reduction in Colon Cancer Patients
Mario Schootman, Chenghui Li, Jun Ying, Sonia T. Orcutt, Jonathan Laryea
Journal of Surgical Research.2024; 295: 587. CrossRef
Analysis of decision-making factors for defunctioning ileostomy after rectal cancer surgery and their impact on perioperative recovery: a retrospective study of 1082 patients
Xiaojiang Yi, Huaguo Yang, Hongming Li, Xiaochuang Feng, Weilin Liao, Jiaxin Lin, Zhifeng Chen, Dechang Diao, Manzhao Ouyang
Surgical Endoscopy.2024; 38(11): 6782. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis
I. Vogel, M. Shinkwin, S. L. van der Storm, J. Torkington, J. A.Cornish, P. J. Tanis, R. Hompes, W. A. Bemelman
Techniques in Coloproctology.2022; 26(5): 333. CrossRef
Postoperative paralytic ileus following debulking surgery in ovarian cancer patients
Eva K. Egger, Freya Merker, Damian J. Ralser, Milka Marinova, Tim O. Vilz, Hanno Matthaei, Tobias Hilbert, Alexander Mustea
Frontiers in Surgery.2022;[Epub] CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Case Report

Benign GI diease,Benign diesease & IBD,Complication

Clostridium difficile Infection After Ileostomy Reversal: Ho Seung Kim, Jae Hyun Kang, Han-gil Kim, Young Hun Kim, Hyeonwoo Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S4-S6. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.24

5,799 View
129 Download
2 Web of Science
2 Citations

Abstract PDF

Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.

Citations

Citations to this article as recorded by

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Malignant disease, Functional outcomes

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings: Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2020;36(1):17-21. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.25

5,561 View
80 Download
1 Web of Science
2 Citations

Abstract PDF

Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

Citations

Citations to this article as recorded by

Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Journal of Minimally Invasive Surgery.2025; 28(1): 47. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef

Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery: Yoo Jin Choi, Jung-Myun Kwak, Neul Ha, Tae Hoon Lee, Se Jin Baek, Jin Kim, Seon Hahn Kim; Ann Coloproctol. 2019;35(4):187-193. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.1

8,149 View
187 Download
12 Web of Science
13 Citations

Abstract PDF

Purpose
No guidelines exist detailing when to implement a temporary ileostomy closure in the setting of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer. The aim of this study was to evaluate the clinical and oncological outcomes of ileostomy closure during adjuvant chemotherapy in patients with curative resection of rectal cancer.
Methods
This retrospective study investigated 220 patients with rectal cancer undergoing sphincter-saving surgery with protective loop ileostomy from January 2007 to August 2016. Patients were divided into 2 groups: group 1 (n = 161) who underwent stoma closure during adjuvant chemotherapy and group 2 (n = 59) who underwent stoma closure after adjuvant chemotherapy.
Results
No significant differences were observed in operative time, blood loss, postoperative hospital stay, or postoperative complications in ileostomy closure between the 2 groups. No difference in overall survival (P = 0.959) or disease-free survival (P = 0.114) was observed between the 2 groups.
Conclusion
Ileostomy closure during adjuvant chemotherapy was clinically safe, and interruption of chemotherapy due to ileostomy closure did not change oncologic outcomes.

Citations

Citations to this article as recorded by

Early closure of protective ileostomy—a benefit for the patient?
Zuzana Adamová, Michaela Filová, Veronika Pechalová, Martin Chrostek, Radim Slováček
European Surgery.2025; 57(4): 172. CrossRef
Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer
Fan He, Fuyu Yang, Chenglin Tang, Defei Chen, Dongqin Zhao, Junjie Xiong, Yu Zou, Guoquan Huang, Kun Qian, Masanao Nakamura
Canadian Journal of Gastroenterology and Hepatology.2024; 2024: 1. CrossRef
Prophylactic effect of retromuscular mesh placement during loop ileostomy closure on incisional hernia incidence—a multicentre randomised patient- and observer-blind trial (P.E.L.I.O.N trial)
Sven Müller, Dirk Weyhe, Florian Herrle, Philipp Horvath, Robert Bachmann, Viktor von Ehrlich-Treuenstätt, Patrick Heger, Nadir Nasir, Christina Klose, Alexander Ritz, Anja Sander, Erich Grohmann, Colette Dörr-Harim, André L. Mihaljevic
Trials.2023;[Epub] CrossRef
Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre
H.-H. Cheng, Y.-C. Shao, C.-Y. Lin, T.-W. Chiang, M.-C. Chen, T.-Y. Chiu, Y.-L. Huang, C.-C. Chen, C.-P. Chen, F.-F. Chiang
Techniques in Coloproctology.2023; 27(12): 1227. CrossRef
Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients
Kun-Yu Tsai, Jeng-Fu You, Shu-Huan Huang, Tzong-yun Tsai, Pao-Shiu Hsieh, Cheng-Chou Lai, Wen-Sy Tsai, Hsin-Yuan Hung
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Early versus late closure of temporary ileostomy after rectal cancer surgery: a meta-analysis
Li Wang, Xinling Chen, Chen Liao, Qian Wu, Hongliang Luo, Fengming Yi, Yiping Wei, Wenxiong Zhang
Surgery Today.2021; 51(4): 463. CrossRef
Low albumin level and longer interval to closure increase the early complications after ileostomy closure
HyungJoo Baik, Ki Beom Bae
Asian Journal of Surgery.2021; 44(1): 352. CrossRef
Does the timing of protective ileostomy closure post-low anterior resection have an impact on the outcome? A retrospective study
Fozan Sauri, Ahmad Sakr, Ho Seung Kim, Mohammed Alessa, Radwan Torky, Eman Zakarneh, Seung Yoon Yang, Nam Kyu Kim
Asian Journal of Surgery.2021; 44(1): 374. CrossRef
Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis
I. Vogel, N. Reeves, P. J. Tanis, W. A. Bemelman, J. Torkington, R. Hompes, J. A. Cornish
Techniques in Coloproctology.2021; 25(7): 751. CrossRef
Clinical Outcomes of Ileostomy Closure before Adjuvant Chemotherapy after Rectal Cancer Surgery: An Observational Study from a Chinese Center
Zhen Sun, Yufeng Zhao, Lu Liu, Jichao Qin, Zhongguang Luo
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Delayed ileostomy closure increases the odds of Clostridium difficile infection
Simon J. G. Richards, Dilshan K. Udayasiri, Ian T. Jones, Ian A. Hastie, Raaj Chandra, Jacob J. McCormick, Timothy J. Chittleborough, David J. Read, Ian P. Hayes
Colorectal Disease.2021; 23(12): 3213. CrossRef
The effect of ileostomy closure timing on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer
Hemn Hussain Kaka Ali, Qalandar Hussein Abdulkarim, Karzan Seerwan, Barham M. M .Salih, Omar H Ghalib Hawramy, Dara Ahmed Mohammed, Syamand Orhaman Ahmed
Kurdistan Journal of Applied Research.2021; : 126. CrossRef
Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients
Marcin Zeman, Marek Czarnecki, Andrzej Chmielarz, Adam Idasiak, Maciej Grajek, Agnieszka Czarniecka
World Journal of Surgical Oncology.2020;[Epub] CrossRef

Anastomotic Sinus That Developed From Leakage After a Rectal Cancer Resection: Should We Wait for Closure of the Stoma Until the Complete Resolution of the Sinus?: Chris Tae-Young Chung, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2019;35(1):30-35. Published online January 25, 2019; DOI: https://doi.org/10.3393/ac.2018.08.13

7,931 View
158 Download
5 Web of Science
5 Citations

Abstract PDF

Purpose
The aims of this study were to identify the clinical characteristics of an anastomotic sinus and to assess the validity of delaying stoma closure in patients until the complete resolution of an anastomotic sinus.
Methods
The subject patients are those who had undergone a resection of rectal cancer from 2011 to 2017, who had a diversion ileostomy protectively or therapeutically and who developed a sinus as a sequelae of anastomotic leakage. The primary outcomes that were measured were the incidence, management and outcomes of an anastomotic sinus.
Results
Of the 876 patients who had undergone a low anterior resection, 14 (1.6%) were found to have had an anastomotic sinus on sigmoidoscopy or a gastrografin enema before their ileostomy closure. In the 14 patients with a sinus, 7 underwent ileostomy closure as scheduled, with a mean closure time of 4.1 months. The remaining 7 patients underwent ileostomy repair, but it was delayed until after the follow-up for the widening of the sinus opening by using digital dilation, with a mean closure time of 6.9 months. Four of those remaining seven patients underwent stoma closure even though their sinus condition had not yet been completely resolved. No pelvic septic complications occurred after closure in any of the 14 patients with an anastomotic sinus, but 2 of the 14 needed a rediversion due to a severe anastomotic stricture.
Conclusion
Patients with an anastomotic sinus who had been carefully selected underwent successful ileostomy closure without delay.

Citations

Citations to this article as recorded by

Management of Low-Rectal Anastomotic Sinus With Transanal Minimally Invasive Septotomy
Nirvana B. Saraswat, Scott A. Brill, William E. Wise
The American Surgeon™.2023; 89(2): 322. CrossRef
The management of asymptomatic radiological anastomotic leakage following anterior resection
Mohamed Rabie, Laura Parry, Iannish Sadien, Sandeep Kapur, Adam Stearns, Irshad Shaikh
ANZ Journal of Surgery.2022; 92(4): 801. CrossRef
Chronische Anastomoseninsuffizienz nach tiefer Rektumresektion – ein ungelöstes Problem?
Peter Kienle, Jörn Richard Magdeburg
Der Chirurg.2021; 92(7): 605. CrossRef
Response to Dioscoridi et al.
G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. T. Kjossev, M. S. Tabakov
Colorectal Disease.2020; 22(7): 841. CrossRef
Anastomotic Sinus Developed From Leakage in Rectal Cancer Resection: When Can We Reverse the Defunctioning Stoma?
Chang Hyun Kim
Annals of Coloproctology.2019; 35(1): 1. 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

7,217 View
166 Download
6 Web of Science
9 Citations

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

Multidisciplinary management of a patient with vesicosigmoid fistula and multisystem diseases undergoing stoma reversal: a case report
Jian Yang, Li Zhang, Ke Zeng
BMC Surgery.2026;[Epub] CrossRef
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

Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-ichi Kosugi, Toshifumi Wakai; Ann Coloproctol. 2018;34(2):94-100. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14

10,602 View
117 Download
12 Web of Science
11 Citations

Abstract PDF

Purpose
Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC.
Methods
The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters.
Results
The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO.
Conclusion
The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

Citations

Citations to this article as recorded by

Management of J-pouch Complications
Beatrix H. Choi, David Cohen, Caleah Kitchens, David M. Schwartzberg
Surgical Clinics of North America.2025; 105(2): 357. CrossRef
Influence of the rotation of the diverting loop ileostomy in rectal cancer surgery on small-bowel obstruction: A multicenter prospective study conducted by the Clinical Study Group of Osaka University, Colorectal Group
Masaaki Miyo, Mamoru Uemura, Yuki Ozato, Junichi Nishimura, Ken Nakata, Yozo Suzuki, Yoshinori Kagawa, Taishi Hata, Koji Munakata, Mitsuyoshi Tei, Genta Sawada, Shinichi Yoshioka, Yusuke Takahashi, Koji Oba, Tsuyoshi Hata, Takayuki Ogino, Norikatsu Miyosh
Surgery.2025; 178: 108874. CrossRef
Risk factors for stoma outlet obstruction: systematic review and meta-analysis
Ali Toffaha, Ahmed Badr, Mahmood Al-Dhaheri, Ammar Aleter, Ejaz Latif, Mohamed Kurer, Ayman Ahmed, Noof Al Naimi, Issam Abu-Issa, Tausief Fatima, Amjad Parvaiz, Mohamed Abu Nada
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis
Keisuke Ihara, Takatoshi Nakamura, Masashi Takayanagi, Junki Fujita, Yasunori Maeda, Yusuke Nishi, Norisuke Shibuya, Hiroyuki Hachiya, Mitsuru Ishizuka, Keiichi Tominaga, Kazuyuki Kojima, Atsushi Irisawa
Journal of the Anus, Rectum and Colon.2024; 8(1): 18. CrossRef
Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review
Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee
Annals of Coloproctology.2024; 40(5): 424. CrossRef
Association Between Advanced T Stage and Thick Rectus Abdominis Muscle and Outlet Obstruction and High-Output Stoma After Ileostomy in Patients With Rectal Cancer
Yasuhiro Komatsu, Kunitoshi Shigeyasu, Sho Takeda, Yoshiko Mori, Kazutaka Takahashi, Nanako Hata, Kokichi Miyamoto, Hibiki Umeda, Yoshihiko Kakiuchi, Satoru Kikuchi, Shuya Yano, Shinji Kuroda, Yoshitaka Kondo, Hiroyuki Kishimoto, Fuminori Teraishi, Masahi
International Surgery.2022; 106(3): 102. CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef
Risk factors and management of stoma-related obstruction after laparoscopic colorectal surgery with diverting ileostomy
Ryo Maemoto, Shingo Tsujinaka, Yasuyuki Miyakura, Rintaro Fukuda, Nao Kakizawa, Tsutomu Takenami, Erika Machida, Nozomi Kikuchi, Rina Kanemitsu, Sawako Tamaki, Hideki Ishikawa, Toshiki Rikiyama
Asian Journal of Surgery.2021; 44(8): 1037. CrossRef
RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS OF ILEAL POUCH IN PATIENTS WITH ULCERATIVE COLITIS
S. I. Achkasov, O. I. Sushkov, A. E. Kulikov, Sh. A. Binnatli, M. A. Nagudov, A. V. Vardanyan
Koloproktologia.2020; 19(1): 51. CrossRef
A Common Complication After an Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Small Bowel Obstruction
Chang-Nam Kim
Annals of Coloproctology.2018; 34(2): 57. CrossRef
Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
Surgery Today.2018; 48(12): 1060. CrossRef

Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial: Mina Alvandipour, Babak Gharedaghi, Hamed Khodabakhsh, Mohammad Yasin Karami; Ann Coloproctol. 2016;32(4):144-149. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.144

8,120 View
89 Download
21 Web of Science
25 Citations

Abstract PDF

Purpose

Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound.

Methods

This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire.

Results

Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043).

Conclusion

After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.

Citations

Citations to this article as recorded by

Gunsight closure versus conventional techniques for reversal of protective stoma after rectal cancer surgery: a propensity score matching study
Senbin Lin, Misha Mao, Rui Chen, Linnan Guo, Mengya Zhou, Jianhui Chen
International Journal of Colorectal Disease.2026;[Epub] CrossRef
Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
Brian Williams, Aubrey Swinford, Jordan Martucci, Johnny Wang, Jordan R. Wlodarczyk, Abhinav Gupta, Kyle G. Cologne, Sarah E. Koller, Christine Hsieh, Marjun P. Duldulao, Joongho Shin
Surgery Open Science.2025; 23: 69. CrossRef
Usefulness of a negative pressure wound therapy system for stoma closure
Chisato Shirakawa, Yuzuru Sakamoto, Shinya Ueki, Hiroki Shomura, Keizo Kazui, Akinobu Taketomi
Journal of Wound Care.2025; 34(2): 106. CrossRef
Circular (purse-string) vs primary skin closure following stoma closure: an up-to-date systematic review and meta-analysis
F. Menegon Tasselli, F. Pata, G. Fuschillo, G. Signoriello, A. Bondurri, G. Sciaudone, F. Selvaggi, G. Pellino
Techniques in Coloproctology.2025;[Epub] CrossRef
Primary closure of ileostomy site after irrigation with betaine–polyhexanide: a case series
Henry Krasner, Abigail W Cheng, Lance Horner, Ovunc Bardakcioglu
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Comparison of purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies
Filippo Carannante, Guglielmo Niccolò Piozzi, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Vincenzo Schiavone, Jim S. Khan, Marco Caricato, Gabriella Teresa Capolupo
Annals of Coloproctology.2025; 41(6): 491. CrossRef
The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial
Assad Ameer, Muhammad Bilal Mirza, Nabila Talat
Journal of Pediatric Surgery.2024; 59(6): 1186. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal
Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial
Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review
Jinlong Luo, Dan Liu, Junmei Wu, Huaiwu Jiang, Jin Chen, Hua Yang, Lie Yang
Medicine.2024; 103(35): e39477. CrossRef
Short-term outcomes following purse-string versus conventional closure of ileostomy wounds in Chinese colorectal cancer patients — a single center retrospective study
Yu-Rong Jiao, Xin-Bin Zhou, Yao Ye, Qian Xiao, Xiang-Xing Kong, Ke-Feng Ding, Jun Li
Holistic Integrative Oncology.2023;[Epub] CrossRef
Results of application of the technique of the extraperitoneal closure of loop intestinal stoma
N. A. Maistrenko, A. A. Sazonov, P. N. Romashchenko, M. V. Zotov
Grekov's Bulletin of Surgery.2023; 181(6): 64. CrossRef
Wound Infection After Ileostomy Closure: An Interim Analysis of a Prospective Randomized Study Comparing Primary Versus Circumferential Subcuticular Closure Techniques
Sumesh Kaistha, Rajesh Panwar, Sujoy Pal, Nihar Ranjan Dash, Peush Sahni, Tushar Kanti Chattopadhyay
Surgical Infections.2023; 24(9): 797. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal
Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw
Cochrane Database of Systematic Reviews.2022;[Epub] CrossRef
COMPARISON BETWEEN OSTOMY CLOSURE USING PURSE-STRING VERSUS LINEAR IN CHILDREN
Shahnam Askarpour, Mehran Peyvasteh, Farbod Farhadi, Hazhir Javaherizadeh
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2022;[Epub] CrossRef
Negative-pressure wound therapy after stoma reversal in colorectal surgery: a randomized controlled trial
Francesco M Carrano, Annalisa Maroli, Michele Carvello, Caterina Foppa, Matteo Sacchi, Jacopo Crippa, Giuseppe Clerico, Francesca De Lucia, Elisabetta Coppola, Nadav Ben David, Antonino Spinelli
BJS Open.2021;[Epub] CrossRef
Evidence-based adoption of purse-string skin closure for stoma wounds
Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi
Medical Journal Armed Forces India.2020; 76(2): 185. CrossRef
Gunsight Procedure Versus the Purse-String Procedure for Closing Wounds After Stoma Reversal: A Multicenter Prospective Randomized Trial
Jia Gang Han, Hong Wei Yao, Jian Ping Zhou, Hong Zhang, Gui Ying Wang, Zhan Long Shen, Jian Feng Gong, Zhen Jun Wang
Diseases of the Colon & Rectum.2020; 63(10): 1411. CrossRef
Quality of life following ostomy reversal with purse-string vs linear skin closure: a systematic review
Emanuele Rausa, M. E. Kelly, G. Sgroi, V. Lazzari, A. Aiolfi, F. Cavalcoli, G. Bonitta, L. Bonavina
International Journal of Colorectal Disease.2019; 34(2): 209. CrossRef
Purse-string vs. linear skin closure at loop ileostomy reversal: a systematic review and meta-analysis
M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi
Techniques in Coloproctology.2019; 23(3): 207. CrossRef
Italian guidelines for the surgical management of enteral stomas in adults
F. Ferrara, D. Parini, A. Bondurri, M. Veltri, M. Barbierato, F. Pata, F. Cattaneo, A. Tafuri, C. Forni, G. Roveron, G. Rizzo
Techniques in Coloproctology.2019; 23(11): 1037. CrossRef
Purse-string closure versus conventional primary closure of wound following stoma reversal: Meta-analysis of randomized controlled trials
Fabio Rondelli, Laura Franco, Ruben Carlo Balzarotti Canger, Graziano Ceccarelli, Cecilia Becattini, Walter Bugiantella
International Journal of Surgery.2018; 52: 208. CrossRef
Purse-string skin closure versus linear skin closure techniques in stoma closure: a comprehensive meta-analysis with trial sequential analysis of randomised trials
Shahab Hajibandeh, Shahin Hajibandeh, Andrew Kennedy-Dalby, Sheik Rehman, Reza Arsalani Zadeh
International Journal of Colorectal Disease.2018; 33(10): 1319. CrossRef
LOOP ILEOSTOMY CLOSURE (review)
I. S. Lantsov, A. I. Moskalev, O. I. Sushkov
Koloproktologia.2018; (2): 102. CrossRef
The effect of purse-string approximation versus linear approximation of ileostomy reversal wounds on morbidity rates and patient satisfaction: the 'STOMA' trial
D. P. O’Leary, M. Carter, D. Wijewardene, M. Burton, D. Waldron, E. Condon, J. C. Coffey, C. Peirce
Techniques in Coloproctology.2017; 21(11): 863. CrossRef

Biofeedback Therapy Before Ileostomy Closure in Patients Undergoing Sphincter-Saving Surgery for Rectal Cancer: A Pilot Study: Jeong-Ki Kim, Byeong Geon Jeon, Yoon Suk Song, Mi Sun Seo, Yoon-Hye Kwon, JI Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park; Ann Coloproctol. 2015;31(4):138-143. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.138

6,209 View
69 Download
14 Web of Science
14 Citations

Abstract PDF

Purpose

This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and subjective bowel function in patients after sphincter-saving surgery for rectal cancer.

Methods

Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study. Conservative management included lifestyle modifications, Kegel exercises, and medication. Patients were evaluated at baseline and at 1, 3, 6, and 12 months after ileostomy closure by using anal manometry, modified Wexner Incontinence Scores (WISs), and fecal incontinence quality of life (FI-QoL) scores.

Results

Before the ileostomy closure, the groups did not differ in baseline clinical characteristics or resting manometric parameters. After 12 months of follow-up, the biofeedback group demonstrated a statistically significant improvement in the mean maximum squeezing pressure (from 146.3 to 178.9, P = 0.002). However, no beneficial effect on the WIS was noted for biofeedback compared to conservative management alone. Overall, the FI-QoL scores were increased significantly in both groups after ileostomy closure (P = 0.006), but did not differ significantly between the two groups.

Conclusion

Although the biofeedback therapy group demonstrated a statistically significant improvement in the maximum squeezing pressure, significant improvements in the WISs and the FI-QoL scores over time were noted in both groups. The study was terminated early because no therapeutic benefit of biofeedback had been demonstrated.

Citations

Citations to this article as recorded by

Effectiveness of pelvic floor muscle training in the recovery of patients after low anterior resection: A systematic review and meta-analysis
Min Jeong Kim, Seonmi Yeom, Young Man Kim
European Journal of Oncology Nursing.2025; 77: 102918. CrossRef
BENEFÍCIOS DA FISIOTERAPIA EM PACIENTES COLOSTOMIZADOS E ILEOSTOMIZADOS: UMA REVISÃO NARRATIVA
Ana Carolina Aboukalam da Cruz, Anderson Viana Pantoja, Leonardo Gomes de Souza, Maicon Maximiliano de Almeida, Marcus Vinicius Henriques Brito, George Alberto da Silva Dias
REVISTA FOCO.2025; 18(7): e9137. CrossRef
The effectiveness of physiotherapy interventions on fecal incontinence and quality of life following colorectal surgery: a systematic review and meta-analysis of randomized controlled trials
Ming Yan Pun, Pak Ho Leung, Tsz Ching Chan, Chunn Pang, Kin Hei Chan, Priya Kannan
Supportive Care in Cancer.2024;[Epub] CrossRef
Application of pelvic floor rehabilitation in patients with colorectal cancer: a scoping review
Lu Zhou, Changkun Zhong, Yuanyuan Su, Zhengyang Zhang, Ling Wang
Techniques in Coloproctology.2024;[Epub] CrossRef
Effectiveness of Pelvic Floor Muscle Training for Patients Following Low Anterior Resection
Young Man Kim, Eui Geum Oh
Journal of Wound, Ostomy & Continence Nursing.2023; 50(2): 142. CrossRef
ILEOSTIM trial: a study protocol to evaluate the effectiveness of efferent loop stimulation before ileostomy reversal
N. Blanco, I. Oliva, P. Tejedor, E. Pastor, A. Alvarellos, C. Pastor, J. Baixauli, J. Arredondo
Techniques in Coloproctology.2023; 27(12): 1251. CrossRef
Low anterior resection syndrome
Seung‐Bum Ryoo
Annals of Gastroenterological Surgery.2023; 7(5): 719. CrossRef
Efficacy of Pelvic Floor Muscle Training for Postoperative Patients With Rectal Cancer: A Systematic Review and Meta-Analysis
Yuki Nakashima, Kenichi Fudeyasu, Yuki Kataoka, Shunsuke Taito, Takashi Ariie, Yukio Mikami
Cureus.2023;[Epub] CrossRef
„Low anterior resection syndrome“ – Ursachen und therapeutische Ansätze
Sigmar Stelzner, Juliane Kupsch, Sören Torge Mees
Der Chirurg.2021; 92(7): 612. CrossRef
Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer
S -B Ryoo, J W Park, D W Lee, M A Lee, Y -H Kwon, M J Kim, S H Moon, S -Y Jeong, K J Park
British Journal of Surgery.2021; 108(6): 644. CrossRef
Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients: An Observational Study
Mateusz Rubinkiewicz, Jan Witowski, Michał Wysocki, Magdalena Pisarska, Stanisław Kłęk, Andrzej Budzyński, Michał Pędziwiatr
Journal of Clinical Medicine.2019; 8(10): 1567. CrossRef
Mind–Body Interventions for Irritable Bowel Syndrome Patients in the Chinese Population: a Systematic Review and Meta-Analysis
Weidong Wang, Fang Wang, Feng Fan, Ana Cristina Sedas, Jian Wang
International Journal of Behavioral Medicine.2017; 24(2): 191. CrossRef
Lentivirus‐mediated shRNA interference of ghrelin receptor blocks proliferation in the colorectal cancer cells
An Liu, Chenggang Huang, Jia Xu, Xuehong Cai
Cancer Medicine.2016; 5(9): 2417. CrossRef
Biofeedback Therapy After Sphincter-Preservation Surgery for the Treatment of Rectal Cancer
Ik Yong Kim
Annals of Coloproctology.2015; 31(4): 119. CrossRef

Multivariate Analysis of Risk Factors Associated With the Nonreversal Ileostomy Following Sphincter-Preserving Surgery for Rectal Cancer: Young Ah Kim, Gil Jae Lee, Sung Won Park, Won-Suk Lee, Jeong-Heum Baek; Ann Coloproctol. 2015;31(3):98-102. Published online June 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.3.98

6,282 View
36 Download
20 Web of Science
21 Citations

Abstract PDF

Purpose

A loop ileostomy is used to protect an anastomosis after anal sphincter-preserving surgery, especially in patients with low rectal cancer, but little information is available concerning risk factors associated with a nonreversal ileostomy. The purpose of this study was to identify risk factors of ileostomy nonreversibility after a sphincter-saving resection for rectal cancer.

Methods

Six hundred seventy-nine (679) patients with rectal cancer who underwent sphincter-preserving surgery between January 2004 and December 2011 were evaluated retrospectively. Of the 679, 135 (19.9%) underwent a defunctioning loop ileostomy of temporary intent, and these patients were divided into two groups, that is, a reversal group (RG, 112 patients) and a nonreversal group (NRG, 23 patients) according to the reversibility of the ileostomy.

Results

In 23 of the 135 rectal cancer patients (17.0%) that underwent a diverting ileostomy, stoma reversal was not possible for the following reasons; stage IV rectal cancer (11, 47.8%), poor tone of the anal sphincter (4, 17.4%), local recurrence (2, 8.7%), anastomotic leakage (1, 4.3%), radiation proctitis (1, 4.3%), and patient refusal (4, 17.4%). The independent risk factors of the nonreversal group were anastomotic leakage or fistula, stage IV cancer, local recurrence, and comorbidity.

Conclusion

Postoperative complications such as anastomotic leakage or fistula, advanced primary disease (stage IV), local recurrence and comorbidity were identified as risk factors of a nonreversal ileostomy. These factors should be considered when drafting prudential guidelines for ileostomy closure.

Citations

Citations to this article as recorded by

Early vs. Late Stoma Reversal After Open Low Anterior Resection Post-Neoadjuvant Chemoradiotherapy
Fahad Bin Abdul Majeed, Madhu Muralee, Chandramohan
Indian Journal of Surgical Oncology.2025; 16(1): 94. CrossRef
Preoperative risk factors and cumulative incidence of temporary ileostomy non-closure after sphincter-preserving surgery for rectal cancer: a meta-analysis
Fan He, Chenglin Tang, Fuyu Yang, Defei Chen, Junjie Xiong, Yu Zou, Dongqin Zhao, Kun Qian
World Journal of Surgical Oncology.2024;[Epub] CrossRef
SafeHeal Colovac Colorectal Anastomosis Protection Device evaluation (SAFE‐2) pivotal study: an international randomized controlled study to evaluate the safety and effectiveness of the Colovac Colorectal Anastomosis Protection Device
Elisabeth Hain, Jérémie H. Lefèvre, Alison Ricardo, Sang Lee, Karen Zaghiyan, Elisabeth McLemore, Danny Sherwinter, Rebecca Rhee, Matthew Wilson, Joseph Martz, Justin Maykel, John Marks, Jorge Marcet, Philippe Rouanet, Leon Maggiori, Niels Komen, Nicolas
Colorectal Disease.2024; 26(6): 1271. CrossRef
The Determinants of Long-Term Outcomes After Colorectal Cancer Surgery: A Literature Review
Olorungbami K Anifalaje, Charles Ojo, Oluwaseyi T Balogun, Fikayo A Ayodele, Abeeb Azeez, Shirley Gabriels
Cureus.2024;[Epub] CrossRef
Determination of Factors Related to the Reversal and Perioperative Outcomes of Defunctioning Ileostomies in Patients Undergoing Rectal Cancer Surgery: A Regression Analysis Model
Ioannis Baloyiannis, Konstantinos Perivoliotis, Ioannis Mamaloudis, Effrosyni Bompou, Chamaidi Sarakatsianou, George Tzovaras
Journal of Gastrointestinal Cancer.2023; 54(3): 782. CrossRef
Effect of 3D Animation Combined with Teach-Back Health Education on Pelvic Floor Muscle Training in LARS Patients: A Randomized Controlled Trial
Jingjing Ye, Xiaoyan Xu, Shengnian Lu, Xiaojun Xu, Hanmei Liu, Mingxian Luo, Jiamei Zhou, Lianhong Wang, Yongmei Zhang, Nabeel Al-Yateem
Journal of Nursing Management.2023; 2023: 1. CrossRef
Risk factors and incidence of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma: A systematic review and meta-analysis
Lu Zhou, Zuming Qin, Ling Wang
European Journal of Surgical Oncology.2023; 49(12): 107120. CrossRef
Temporary Stomas after Rectal Cancer Resection; Predilection of Being Permanent and Predictors of Complications?
Islam H. Metwally, Mohamed Abdelkhalek, Mohammad Zuhdy, Saleh S. Elbalka
Journal of Coloproctology.2023; 43(03): e191. CrossRef
The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients
Ian Fukudome, Hiromichi Maeda, Ken Okamoto, Hajime Kuroiwa, Sachi Yamaguchi, Kazune Fujisawa, Mai Shiga, Ken Dabanaka, Michiya Kobayashi, Tsutomu Namikawa, Kazuhiro Hanazaki
Patient Safety in Surgery.2021;[Epub] CrossRef
Risk factors associated with non-closure of defunctioning stoma in patients with rectal cancer: univariate and multivariate analysis
M.V. Alekseev, Yu.A. Shelygin, E.G. Rybakov
Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (2): 40. CrossRef
Morbidity and costs of diverting ileostomy in transanal total mesorectal excision with primary anastomosis for rectal cancer
J. C. Hol, F. Bakker, N. T. van Heek, G. M. de Jong, F. M. Kruyt, C. Sietses
Techniques in Coloproctology.2021; 25(10): 1133. CrossRef
Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study
Bao-Jia Luo, Mei-Chun Zheng, Yang Xia, Zhu Ying, Jian-Hong Peng, Li-Ren Li, Zhi-Zhong Pan, Hui-Ying Qin
European Journal of Oncology Nursing.2021; 55: 102059. CrossRef
Predictors of permanent stoma creation in patients with mid or low rectal cancer: results of a multicentre cohort study with preoperative evaluation of anal function
S. Kim, M. H. Kim, J. H. Oh, S.‐Y. Jeong, K. J. Park, H.‐K. Oh, D.‐W. Kim, S.‐B. Kang
Colorectal Disease.2020; 22(4): 399. CrossRef
The fate of preserved sphincter in rectal cancer patients
Ri Na Yoo, Gun Kim, Bong-Hyeon Kye, Hyeon-Min Cho, HyungJin Kim
International Journal of Colorectal Disease.2018; 33(6): 745. CrossRef
Patients With Temporary Ostomies
Mohammed Iyoob Mohammed Ilyas, David A. Haggstrom, Melinda A. Maggard-Gibbons, Christopher S. Wendel, Susan Rawl, Christian Max Schmidt, Clifford Y. Ko, Robert S. Krouse
Journal of Wound, Ostomy & Continence Nursing.2018; 45(6): 510. CrossRef
Risk Factors Associated With Nonclosure of Defunctioning Stomas After Sphincter-Preserving Low Anterior Resection of Rectal Cancer: A Meta-Analysis
Xin Zhou, Bingyan Wang, Fei Li, Jilian Wang, Wei Fu
Diseases of the Colon & Rectum.2017; 60(5): 544. CrossRef
Use of a nomogram to predict the closure rate of diverting ileostomy after low anterior resection: A retrospective cohort study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Koji Murono, Shigenobu Emoto, Toshiaki Watanabe
International Journal of Surgery.2017; 47: 83. CrossRef
Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer
Mustafa Haksal, Nuri Okkabaz, Ali Emre Atici, Osman Civil, Yasar Ozdenkaya, Ayhan Erdemir, Nihat Aksakal, Mustafa Oncel
Annals of Surgical Treatment and Research.2017; 92(1): 35. CrossRef
Current Status of the Watch-and-Wait Policy for Patients with Complete Clinical Response Following Neoadjuvant Chemoradiation in Rectal Cancer
Rob Glynne-Jones, Rob Hughes
Current Colorectal Cancer Reports.2017; 13(1): 17. CrossRef
Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer
Tzu-Chieh Yin, Hsiang-Lin Tsai, Ping-Fu Yang, Wei-Chih Su, Cheng-Jen Ma, Ching-Wen Huang, Ming-Yii Huang, Chun-Ming Huang, Jaw-Yuan Wang
World Journal of Surgical Oncology.2017;[Epub] CrossRef
Stoma Creation After Surgery for Rectal Cancer: Temporary or Permanent?
Jung Wook Huh
Annals of Coloproctology.2015; 31(3): 82. CrossRef

Predictors of Fecal Incontinence and Related Quality of Life After a Total Mesorectal Excision With Primary Anastomosis for Patients With Rectal Cancer: Marieke S. Walma, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen; Ann Coloproctol. 2015;31(1):23-28. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.23

7,669 View
48 Download
44 Web of Science
42 Citations

Abstract PDF

Purpose

After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL.

Methods

Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis.

Results

A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001).

Conclusion

A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure.

Citations

Citations to this article as recorded by

Clinical analysis of different intestinal reconstruction methods after primary cytoreductive surgery combined with rectal resection for advanced ovarian cancer
Huimin Wang, Xiaocen Li, Ying Jiang, Jinxin Chen, Rong Cao, Jingru Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Y después de la cirugía, ¿qué hay de nuevo para el superviviente de cáncer de recto?
Arturo Cirera de Tudela, Franco Marinello, Eloy Espín Basany
Cirugía Española.2025; 103(4): 237. CrossRef
And after surgery, what’s new for the rectal cancer survivor?
Arturo Cirera de Tudela, Franco Marinello, Eloy Espín Basany
Cirugía Española (English Edition).2025; 103(4): 237. CrossRef
Neoadjuvante Therapie beim Rektumkarzinom – für wen, wie und mit welchem Ziel?
Franziska Willis, Thilo Schwandner, Martin Reichert, Anca-Laura Amati, Daniel Habermehl, Martin Schneider
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2025; 150(02): 140. CrossRef
Effectiveness of pelvic floor muscle training in the recovery of patients after low anterior resection: A systematic review and meta-analysis
Min Jeong Kim, Seonmi Yeom, Young Man Kim
European Journal of Oncology Nursing.2025; 77: 102918. CrossRef
REACT bowel REcovery after CyToreductive surgery for advanced ovarian cancer
Virginia Vargiu, Andrea Rosati, Francesco Santullo, Matteo Figà, Giovanni Esposito, Silvio Andrea Russo, Guido Lancellotti, Carlo Abatini, Claudio Lodoli, Matteo Loverro, Diana Giannarelli, Barbara Costantini, Angelica Naldini, Anna Fagotti
Gynecologic Oncology.2025; 199: 32. CrossRef
Early diverting stoma closure is feasible and safe: results from a before-and-after study on the implementation of an early closure protocol at a tertiary referral center
L. Blanco Terés, C. Cerdán Santacruz, A. Correa Bonito, L. Delgado Búrdalo, A. Rodríguez Sánchez, E. Bermejo Marcos, J. García Septiem, E. Martín Pérez
Techniques in Coloproctology.2024;[Epub] CrossRef
Factors affecting timing of loop ileostomy closure: a regional centre's experience with 106 patients
Tedman Cheuk‐Yiu Chau, Hung Nguyen, Iain K. Robertson, Xavier Harvey, Brendan Tan, Mitchell Tan, Caroline M. Yang
ANZ Journal of Surgery.2024; 94(1-2): 193. CrossRef
The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer
Sanne J. Verkuijl, Jara E. Jonker, Edgar J.B. Furnée, Wendy Kelder, Christiaan Hoff, Daniel A. Hess, Fennie Wit, Ronald J. Zijlstra, Monika Trzpis, Paul M.A. Broens
Diseases of the Colon & Rectum.2024; 67(2): 291. CrossRef
Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study
Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Annals of Coloproctology.2024; 40(1): 27. CrossRef
The Effect of Pelvic Floor Muscle Exercises on Bowel Evacuation and Quality of Life in Following Intestinal Ostomy Closure
Dilek Aktaş, Sema Koçaşlı, Zehra Göçmen Baykara
Journal of Wound, Ostomy & Continence Nursing.2024; 51(3): 221. CrossRef
Nomogram for predicting the probability of rectal anastomotic re-leakage after stoma closure: a retrospective study
Yuegang Li, Gang Hu, Jinzhu Zhang, Wenlong Qiu, Shiwen Mei, Xishan Wang, Jianqiang Tang
BMC Cancer.2024;[Epub] CrossRef
Quality of life and functional outcome of rectal cancer patients: A prospective cohort study
Alexander J. Pennings, Geraldine R. Vink, Sander van Kuijk, Jarno Melenhorst, Geerard L. Beets, Anne M. May, Stephanie O. Breukink
Colorectal Disease.2024; 26(11): 1892. CrossRef
Causes and costs of delayed closure of ileostomies in rectal cancer patients in Australasian units
Jon Barnard, Tony Milne, Keith Teo, Maree Weston, Lincoln Israel, Sze‐Lin Peng
ANZ Journal of Surgery.2023; 93(3): 636. CrossRef
One-Year Treatment-Related Side Effects and Quality of Life After Chemoradiotherapy in Squamous Cell Carcinoma of the Anus
Anna Cecilie Lefèvre, Eva Serup-Hansen, Katrine Smedegaard Storm, Karen Lycke Wind, Camilla Kronborg, Karen-Lise Garm Spindler
International Journal of Radiation Oncology*Biology*Physics.2023; 115(5): 1165. CrossRef
Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis
L. Zhang, Z. Xie, L. Gong, X. Lv
Frontiers in Surgery.2023;[Epub] CrossRef
Management of Low Anterior Resection Syndrome (LARS) Following Resection for Rectal Cancer
Harald Rosen, Christian G. Sebesta, Christian Sebesta
Cancers.2023; 15(3): 778. CrossRef
Patient-reported Bowel Function and Bowel-related Quality of Life After Pelvic Radiation for Rectal Adenocarcinoma: The Impact of Radiation Fractionation and Surgical Resection
Michael K. Rooney, Brian De, Kelsey Corrigan, Grace L. Smith, Cullen Taniguchi, Bruce D. Minsky, Ethan B. Ludmir, Eugene J. Koay, Prajnan Das, Albert C. Koong, Oliver Peacock, George Chang, Y. Nancy You, Van K. Morris, Graciela Nogueras-González, Emma B.
Clinical Colorectal Cancer.2023; 22(2): 211. CrossRef
Prolonged diversion after ileal pouch‐anal anastomosis: Is it safe to wait?
Cillian Clancy, Tara M. Connelly, Xue Jia, Jeremy Lipman, Amy L. Lightner, Tracy Hull, Scott R. Steele, Stefan D. Holubar
Colorectal Disease.2023; 25(6): 1187. CrossRef
The impact of prolonged delay to loop ileostomy closure on postoperative morbidity and hospital stay: A retrospective cohort study
Greg A. Turner, Kari A. Clifford, Rossi Holloway, John C. Woodfield, Mark Thompson‐Fawcett
Colorectal Disease.2022; 24(7): 854. CrossRef
Prevalence and Risk Factors of Low Anterior Resection Syndrome in Epithelial Ovarian Cancer Surgery
Iqra Yasin, Afshan Saeed Usmani, Jibran Mohsin, Rehan Bin Asif, Nazish Kahlid, Aamir Ali Syed
Cureus.2022;[Epub] CrossRef
Patient-Reported Bowel and Urinary Function in Long-Term Survivors of Squamous Cell Carcinoma of the Anus Treated With Definitive Intensity Modulated Radiation Therapy And Concurrent Chemotherapy
Brian De, Kelsey L. Corrigan, Michael K. Rooney, Ethan B. Ludmir, Prajnan Das, Grace L. Smith, Cullen M. Taniguchi, Bruce D. Minsky, Eugene J. Koay, Albert Koong, Van K. Morris, Craig A. Messick, Y. Nancy You, George J. Chang, O. Lenaine Westney, Graciela
International Journal of Radiation Oncology*Biology*Physics.2022; 114(1): 78. CrossRef
The Longitudinal Course of Low-anterior Resection Syndrome
Chris Varghese, Cameron I. Wells, Greg O’Grady, Peter Christensen, Ian P. Bissett, Celia Keane
Annals of Surgery.2022; 276(1): 46. CrossRef
The role of colonic motility in low anterior resection syndrome
Chris Varghese, Cameron I. Wells, Ian P. Bissett, Gregory O’Grady, Celia Keane
Frontiers in Oncology.2022;[Epub] CrossRef
Symptoms of anal incontinence and quality of life: a psychometric study of the Norwegian version of the ICIQ-B amongst hospital outpatients
Susan Saga, Anne Guttormsen Vinsnes, Christine Norton, Gørill Haugan
Archives of Public Health.2022;[Epub] CrossRef
Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis
I. Vogel, N. Reeves, P. J. Tanis, W. A. Bemelman, J. Torkington, R. Hompes, J. A. Cornish
Techniques in Coloproctology.2021; 25(7): 751. CrossRef
Loop-ileostomy reversal in a 23-h stay setting is safe with high patient satisfaction
Kevin Afshari, Maziar Nikberg, Kenneth Smedh, Abbas Chabok
Scandinavian Journal of Gastroenterology.2021; 56(9): 1126. CrossRef
Low anterior resection syndrome: can it be prevented?
Alfredo Annicchiarico, Jacopo Martellucci, Stefano Solari, Maximilian Scheiterle, Carlo Bergamini, Paolo Prosperi
International Journal of Colorectal Disease.2021; 36(12): 2535. CrossRef
Risk factors for developing anorectal dysfunction after anterior resection
Kevin Afshari, Kenneth Smedh, Philippe Wagner, Abbas Chabok, Maziar Nikberg
International Journal of Colorectal Disease.2021; 36(12): 2697. CrossRef
Impact of temporary ileostomy on long‐term quality of life and bowel function: a systematic review and meta‐analysis
Celia Keane, Puja Sharma, Lance Yuan, Ian Bissett, Greg O'Grady
ANZ Journal of Surgery.2020; 90(5): 687. CrossRef
Low anterior resection syndrome (LARS) in ovarian cancer patients - A multi-centre comparative cohort study
Felix Harpain, Marlene Kranawetter, Tobias Zott, Ioannis I. Lazaridis, Marc-Olivier Guenin, Marijana Ninkovic, Irmgard E. Kronberger, Ingrid Tapiolas, Eloy Espin Basany, Bernhard Dauser, Friedrich Herbst, Cherry Koh, Anton Stift, Bela Teleky, Alexander Re
International Journal of Surgery.2020; 78: 97. CrossRef
Functional outcomes from a randomized trial of early closure of temporary ileostomy after rectal excision for cancer
C Keane, J Park, S Öberg, A Wedin, D Bock, G O'Grady, I Bissett, J Rosenberg, E Angenete
British Journal of Surgery.2019; 106(5): 645. CrossRef
Low anterior resection syndrome (LARS) in patients with epithelial ovarian cancer after primary debulking surgery
Marlene Kranawetter, Beyhan Ataseven, Christoph Grimm, Stephanie Schneider, Stefan Riss, Pier Alesina, Sonia Prader, Martin K. Walz, Felix Harpain, Anton Stift, Florian Heitz, Alexander Reinthaller, Stephan Polterauer, Philipp Harter, Andreas du Bois
Gynecologic Oncology.2019; 154(3): 577. CrossRef
Predictive Factors for Bowel Dysfunction After Sphincter-Preserving Surgery for Rectal Cancer: A Single-Center Cross-sectional Study
Youn Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Diseases of the Colon & Rectum.2019; 62(8): 925. CrossRef
Loop-ileostomy reversal—patient-related characteristics influencing time to closure
Carl Pontus Gustafsson, Ulf Gunnarsson, Ursula Dahlstrand, Ulrik Lindforss
International Journal of Colorectal Disease.2018; 33(5): 593. CrossRef
Protocol for a multicentre, dual prospective and retrospective cohort study investigating timing of ileostomy closure after anterior resection for rectal cancer: The CLOSurE of Ileostomy Timing (CLOSE-IT) study
Peter G Vaughan-Shaw, Katherine Gash, Katie Adams, Abigail E Vallance, Sophie A Pilkington, Jared Torkington, Julie A Cornish
BMJ Open.2018; 8(10): e023305. CrossRef
Physiotherapy and Anterior Resection Syndrome (PARiS) trial: feasibility study protocol
Anna Powell-Chandler, Buddug Rees, Carole Broad, Jared Torkington, Claire O’Neill, Julie A Cornish
BMJ Open.2018; 8(6): e021855. CrossRef
Fecal incontinence - Challenges and solutions
Nallely Saldana Ruiz, Andreas M Kaiser
World Journal of Gastroenterology.2017; 23(1): 11. CrossRef
Is the interval from surgery to ileostomy closure a risk factor for low anterior resection syndrome?
R. M. Jiménez‐Rodríguez, J. J. Segura‐Sampedro, I. Rivero‐Belenchón, J. M. Díaz Pavón, A. M. García Cabrera, J. M. Vazquez Monchul, J. Padillo, F. de la Portilla
Colorectal Disease.2017; 19(5): 485. CrossRef
Transanal endoscopic operation for rectal cancer after neoadjuvant therapy
José Joaquim Ribeiro da Rocha, Mário Vinícius Angelete Alvarez Bernardes, Marley Ribeiro Feitosa, Camila Perazzoli, Vanessa Foresto Machado, Fernanda Maris Peria, Harley Francisco de Oliveira, Omar Feres
Acta Cirurgica Brasileira.2016; 31(suppl 1): 29. CrossRef
Low anterior resection syndrome: a survey of the members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP)
Luis Miguel Jimenez-Gomez, Eloy Espin-Basany, Marc Marti-Gallostra, Jose Luis Sanchez-Garcia, Francesc Vallribera-Valls, Manuel Armengol-Carrasco
International Journal of Colorectal Disease.2016; 31(4): 813. CrossRef
Can the Timing of Ileostomy Reversal Influence Functional Outcome?
Chang-Nam Kim
Annals of Coloproctology.2015; 31(1): 5. CrossRef

Feasibility and Safety of a Fold-Over Diverting Ileostomy Reversal After Rectal Cancer Surgery: Case-Matched Comparison to the Resection Technique: Jinock Cheong, Jeonghyun Kang, Im-Kyung Kim, Nam Kyu Kim, Seung-Kook Sohn, Kang Young Lee; Ann Coloproctol. 2014;30(3):118-121. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.118

6,034 View
36 Download
7 Web of Science
6 Citations

Abstract PDF

Purpose

Compared to the stapling technique, the fold-over technique (FO) has the benefit of avoiding the sacrifice of the bowel segment. The aim of this study was to compare short-term outcomes between the FO and a conventional resection.

Methods

Between June 2008 and March 2012, a total of 242 patients who underwent a diverting ileostomy reversal after rectal cancer surgery were selected. Among them, 29 patients underwent the FO. Using propensity scores to adjust for body mass index, previous abdominal surgery history, rectal cancer surgery type (open vs. minimally invasive), and reason for ileostomy (protective aim vs. leakage management), we created a well-balanced cohort by matching each patient who underwent the FO, as the study group, with two patients who underwent a stapled or a hand-sewn technique with bowel resection (RE), as the control group (FO : RE = 1 : 2). Morbidity and perioperative recovery were compared between the two groups.

Results

Twenty-four and forty-eight patients were allocated to the FO and the RE groups, respectively. The mean operation time was 91 ± 26 minutes in the FO group and 97 ± 34 minutes in the RE group (P = 0.494). The overall morbidity rates were not different between the two groups (12.5% in FO vs. 14.6% in RE, P = 1.000). The rate of postoperative ileus was similar between the two groups (8.3% in FO vs. 12.5% in RE, P = 0.710). Although time to resumption of soft diet was shorter in the FO group than in the RE group, the lengths of hospital stay were not different.

Conclusion

The FO and the conventional resection have similar short-term clinical outcomes for diverting ileostomy reversal.

Citations

Citations to this article as recorded by

Comparison of hand-sewn anterior repair, resection and hand-sewn anastomosis, resection and stapled anastomosis techniques for the reversal of diverting loop ileostomy after low anterior rectal resection: a randomized clinical trial
Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Mohammad Reza Keramati, Mehdi Fallahi, Soheila-sadat Nourmohammadi, Alireza Kazemeini, Mohammad Sadegh Fazeli, Amir Keshvari
Techniques in Coloproctology.2024;[Epub] CrossRef
Does the timing of protective ileostomy closure post-low anterior resection have an impact on the outcome? A retrospective study
Fozan Sauri, Ahmad Sakr, Ho Seung Kim, Mohammed Alessa, Radwan Torky, Eman Zakarneh, Seung Yoon Yang, Nam Kyu Kim
Asian Journal of Surgery.2021; 44(1): 374. CrossRef
Modified Colon Leakage Score to Predict Anastomotic Leakage in Patients Who Underwent Left-Sided Colorectal Surgery
Seung Up Yang, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Journal of Clinical Medicine.2019; 8(9): 1450. CrossRef
Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period
Bojan Krebs, Arpad Ivanecz, Stojan Potrc, Matjaz Horvat
Radiology and Oncology.2019; 53(3): 331. CrossRef
Impact of prior abdominal surgery on postoperative prolonged ileus after ileostomy repair
Im-kyung Kim, Jeonghyun Kang, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim, Seung-Kook Sohn
Asian Journal of Surgery.2018; 41(1): 86. CrossRef
Endless Arguments Over Diversion Stomas
Seung Chul Heo
Annals of Coloproctology.2014; 30(3): 103. CrossRef

The Role of Diverting Stoma After an Ultra-low Anterior Resection for Rectal Cancer: Seok In Seo, Chang Sik Yu, Gwon Sik Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2013;29(2):66-71. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.66

9,751 View
52 Download
36 Citations

Abstract PDF

Purpose

A diverting stoma is known to reduce the consequences of distal anastomotic failure following colorectal surgery. The aim of this study was to evaluate the efficacy of a diverting stoma after an ultra-low anterior resection (uLAR) for rectal cancer.

Methods

Between 2000 and 2007, 836 patients who underwent an uLAR were divided into two groups, depending on the fecal diversion: 246 received fecal diversion, and 590 had no diversion. Patient- and disease-related variables were compared between the two groups.

Results

Thirty-two of the 836 patients (3.8%) had immediate anastomosis-related complications and required reoperation. Anastomosis leakage comprised 72% of the complications (23/32). The overall immediate complication rate was significantly lower in patients with a diverting stoma (0.8%, 2/246) compared to those without a diverting stoma (5.1%, 30/590; P = 0.005). The fecal diversion group had lower tumor location, lower anastomosis level, and more preoperative chemo-radiation therapy (P < 0.001). In total, 12% of patients in the diverting stoma group had complications either in making or reversing the stoma (30/246).

Conclusion

The diverting stoma decreased the rate of immediate anastomosis-related complications. However, the rate of complications associated with the diverting stoma was non-negligible, so strict criteria should be applied when deciding whether to use a diverting stoma.

Citations

Citations to this article as recorded by

Patient selection and operative strategies for laparoscopic intersphincteric resection without diverting stoma
Gang Hu, Ji Ma, Wen-Long Qiu, Shi-Wen Mei, Meng Zhuang, Jun Xue, Jun-Guang Liu, Jian-Qiang Tang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Risk factors for permanent stoma following sphincter-preserving anterior resection in rectal cancer: A retrospective multicenter observational study
Pere Planellas, Nair Fernandes, Sandra Alonso-Gonçalves, Thomas Golda, Júlia Gil, Garazi Elorza, Esther Kreisler, Mayra Rebeka Abad-Camacho, Lidia Cornejo, Franco Marinello
Cirugía Española (English Edition).2025; 103(6): 800095. CrossRef
Risk factors for permanent stoma following sphincter-preserving anterior resection in rectal cancer: A retrospective multicenter observational study
Pere Planellas, Nair Fernandes, Sandra Alonso-Gonçalves, Thomas Golda, Júlia Gil, Garazi Elorza, Esther Kreisler, Mayra Rebeka Abad-Camacho, Lidia Cornejo, Franco Marinello
Cirugía Española.2025; 103(6): 800095. CrossRef
Comparison of hand-sewn anterior repair, resection and hand-sewn anastomosis, resection and stapled anastomosis techniques for the reversal of diverting loop ileostomy after low anterior rectal resection: a randomized clinical trial
Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Mohammad Reza Keramati, Mehdi Fallahi, Soheila-sadat Nourmohammadi, Alireza Kazemeini, Mohammad Sadegh Fazeli, Amir Keshvari
Techniques in Coloproctology.2024;[Epub] CrossRef
Complications Rate and Related Factors After Laparoscopic Sphincter-Preserving Total Mesorectal Excision for Low Rectal Cancer: A Single-Center Study in Vietnam
Ly Huu Phu, Ho Tat Bang, Ung Van Viet, Hoang Danh Tan, Nguyen Trung Tin
Cureus.2024;[Epub] CrossRef
Could Stoma Be Avoided after Laparoscopic Low Anterior Resection for Rectal Cancer? Experience with Transanal Tube in 195 Cases
Antonio Sciuto, Roberto Peltrini, Federica Andreoli, Andrea Gianmario Di Santo Albini, Maria Michela Di Nuzzo, Nello Pirozzi, Marcello Filotico, Federica Lauria, Giuseppe Boccia, Michele D’Ambra, Ruggero Lionetti, Carlo De Werra, Felice Pirozzi, Francesco
Journal of Clinical Medicine.2022; 11(9): 2632. CrossRef
Cecostomy vs ileostomy for protection of anastomoses in colorectal surgery
Dan Bratu, Alin Mihețiu, Radu Chicea, Alexandru Sabău
Romanian Journal of Military Medicine.2022; 125(1): 128. CrossRef
A diversion stoma after anterior resection for rectal cancer
Yury V. Ivanov, Aishe A. Keshvedinova, Alexander V. Smirnov
Journal of Clinical Practice.2022; 13(3): 56. CrossRef
Preservation of the Arterial Arc Formed by Left Colic Artery, Proximal Inferior Mesenteric Artery, and the First Branch of Sigmoid Arteries in Anus Saving Treatment of Low Rectal Cancer
Zakari Shaibu, Zhi-hong Chen, Acquah Theophilus, Said A. S. Mzee
The American Surgeon™.2021; 87(12): 1956. CrossRef
Current Treatment Approaches and Outcomes in the Management of Rectal Cancer Above the Age of 80
Ali P. Mourad, Marie Shella De Robles, Soni Putnis, Robert D.R. Winn
Current Oncology.2021; 28(2): 1388. CrossRef
Laparoscopic anterior resection
Senthil Kumar Ganapathi, Rajapandian Subbiah, Sathiyamoorthy Rudramurthy, Harish Kakkilaya, Parthasarathi Ramakrishnan, Palanivelu Chinnusamy
Journal of Minimal Access Surgery.2021; 17(3): 356. CrossRef
The multidisciplinary management of rectal cancer
Deborah S. Keller, Mariana Berho, Rodrigo O. Perez, Steven D. Wexner, Manish Chand
Nature Reviews Gastroenterology & Hepatology.2020; 17(7): 414. CrossRef
Comparison of anastomotic leakage rate and reoperation rate between transanal tube placement and defunctioning stoma after anterior resection: A network meta-analysis of clinical data
Fu-Gang Wang, Wen-Mao Yan, Ming Yan, Mao-Min Song
European Journal of Surgical Oncology.2019; 45(8): 1301. CrossRef
Preventive strategies for anastomotic leakage after colorectal resections: A review
Mostafa Shalaby, Waleed Thabet, Mosaad Morshed, Mohamed Farid, Pierpaolo Sileri
World Journal of Meta-Analysis.2019; 7(8): 389. CrossRef
Neutrophil‐to‐lymphocyte ratio predicts anastomotic dehiscence
Patrick A. Walker, Bindu Kunjuraman, David C. C. Bartolo
ANZ Journal of Surgery.2018;[Epub] CrossRef
Control Comparison of the New EndoWrist and Traditional Laparoscopic Staplers for Anterior Rectal Resection with the Da Vinci Xi: A Case Study
Simone Guadagni, Gregorio Di Franco, Desirée Gianardi, Matteo Palmeri, Cristina Ceccarelli, Matteo Bianchini, Niccolò Furbetta, Giovanni Caprili, Cristiano D'Isidoro, Andrea Moglia, Franca Melfi, Piero Buccianti, Franco Mosca, Luca Morelli
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(12): 1422. CrossRef
Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis
D. P. V. Lambrichts, G. H. J. de Smet, R. D. van der Bogt, L. F. Kroese, A. G. Menon, J. Jeekel, G‐J. Kleinrensink, J. F. Lange
Colorectal Disease.2018;[Epub] CrossRef
Defunctioning ileostomy reduces leakage rate in rectal cancer surgery - systematic review and meta-analysis
Magdalena Pisarska, Natalia Gajewska, Piotr Małczak, Michał Wysocki, Jan Witowski, Grzegorz Torbicz, Piotr Major, Magdalena Mizera, Marcin Dembiński, Marcin Migaczewski, Andrzej Budzyński, Michał Pędziwiatr
Oncotarget.2018; 9(29): 20816. CrossRef
Risk factors for anastomotic leakage after low anterior resection without diversional stomas*
Xiaolong Chen, Libo Feng, Yu Liu, Xiaolong Wu, Jie Xu, Peng Chen, Zhonglin Zuo, Yi Liu, Qingwei Zou, Qing Liu, Dong Xia
Oncology and Translational Medicine.2018; 4(3): 101. CrossRef
Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer
Mustafa Haksal, Nuri Okkabaz, Ali Emre Atici, Osman Civil, Yasar Ozdenkaya, Ayhan Erdemir, Nihat Aksakal, Mustafa Oncel
Annals of Surgical Treatment and Research.2017; 92(1): 35. CrossRef
Is Fecal Diversion Needed in Pelvic Anastomoses During Hyperthermic Intraperitoneal Chemotherapy (HIPEC)?
Matthew D. Whealon, John V. Gahagan, Sarath Sujatha-Bhaskar, Michael P. O’Leary, Matthew Selleck, Sinziana Dumitra, Byrne Lee, Maheswari Senthil, Alessio Pigazzi
Annals of Surgical Oncology.2017; 24(8): 2122. CrossRef
Transanal Inspection and Management of Low Colorectal Anastomosis Performed With a New Technique: the TICRANT Study
Francesco Crafa, Sebastian Smolarek, Giulia Missori, Mostafa Shalaby, Silvia Quaresima, Adele Noviello, Diletta Cassini, Pasquale Ascenzi, Luana Franceschilli, Paolo Delrio, Giannandrea Baldazzi, Ucchino Giampiero, Jacques Megevand, Giovanni Maria Romano,
Surgical Innovation.2017; 24(5): 483. CrossRef
Outcomes of patients with abdominoperineal resection (APR) and low anterior resection (LAR) who had very low rectal cancer
Seung-Seop Yeom, In Ja Park, Sung Woo Jung, Se Heon Oh, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Nayoung Kim, Chang Sik Yu, Jin Cheon Kim
Medicine.2017; 96(43): e8249. CrossRef
Anastomotic leaks in gastrointestinal surgery and their prevention
Tomasz Banasiewicz, Adam Dziki, Paweł Lampe, Zbigniew Lorenc, Marek Szczepkowski, Jacek Zieliński, Grzegorz Wallner
Polish Journal of Surgery.2017; 89(2): 49. CrossRef
ON APPLICATION OF MECHANICAL COLORECTAL ANASTOMOSIS AFTER ANTERIOR RESECTION AND LOW ANTERIOR RECTAL RESECTION
M. F. Cherkasov, A. V. Dmitriev, V. S. Groshilin, S. V. Pereskokov, S. G. Melikova
Koloproktologia.2017; (4): 54. CrossRef
Diverting ileostomy in laparoscopic rectal cancer surgery: high price of protection
Peter Ihnát, Petra Guňková, Matúš Peteja, Petr Vávra, Anton Pelikán, Pavel Zonča
Surgical Endoscopy.2016; 30(11): 4809. CrossRef
Complications of Diverting Ileostomy after Low Anterior Resection for Rectal Carcinoma
Sean Maroney, Carlos Chavez De Paz, Marjunphilip Duldulao, Tracey Kim, Mark E. Reeves, Kevork K. Kazanjian, Naveenraj Solomon, Carlos Garberoglio
The American Surgeon™.2016; 82(10): 1033. CrossRef
Is a diverting ostomy needed in mid-high rectal cancer patients undergoing a low anterior resection after neoadjuvant chemoradiation? An NSQIP analysis
Evangelos Messaris, Tara M. Connelly, Afif N. Kulaylat, Jennifer Miller, Niraj J. Gusani, Gail Ortenzi, Joyce Wong, Neil Bhayani
Surgery.2015; 158(3): 686. CrossRef
Meta-analysis of defunctioning stoma in low anterior resection with total mesorectal excision for rectal cancer: evidence based on thirteen studies
Wen-long Gu, Sheng-wen Wu
World Journal of Surgical Oncology.2015; 13(1): 9. CrossRef
Low anterior resection combined with a covering stoma in the treatment of rectal cancer reduces the risk of permanent anastomotic failure
Minna Räsänen, Laura Renkonen-Sinisalo, Monika Carpelan-Holmström, Anna Lepistö
International Journal of Colorectal Disease.2015; 30(10): 1323. CrossRef
Transanal tube placement for prevention of anastomotic leakage following low anterior resection for rectal cancer: a systematic review and meta-analysis
Gi Won Ha, Hyun Jung Kim, Min Ro Lee
Annals of Surgical Treatment and Research.2015; 89(6): 313. CrossRef
Efficacy of transanal tube for prevention of anastomotic leakage following laparoscopic low anterior resection for rectal cancers: a retrospective cohort study in a single institution
Eiji Hidaka, Fumio Ishida, Shumpei Mukai, Kenta Nakahara, Daisuke Takayanagi, Chiyo Maeda, Yusuke Takehara, Jun-ichi Tanaka, Shin-ei Kudo
Surgical Endoscopy.2015; 29(4): 863. CrossRef
Morbilidad y mortalidad de la ileostomía derivativa temporal en la cirugía por cáncer de recto
Lucinda Pérez Domínguez, María Teresa García Martínez, Nieves Cáceres Alvarado, Ángeles Toscano Novella, Antonio Pedro Higuero Grosso, José Enrique Casal Núñez
Cirugía Española.2014; 92(9): 604. CrossRef
Morbidity and Mortality of Temporary Diverting Ileostomies in Rectal Cancer Surgery
Lucinda Pérez Domínguez, María Teresa García Martínez, Nieves Cáceres Alvarado, Ángeles Toscano Novella, Antonio Pedro Higuero Grosso, José Enrique Casal Núñez
Cirugía Española (English Edition).2014; 92(9): 604. CrossRef
Role of protective stoma in low anterior resection for rectal cancer: A meta-analysis
Sheng-Wen Wu, Cong-Chao Ma, Yu Yang
World Journal of Gastroenterology.2014; 20(47): 18031. CrossRef
Predictive factors for temporary defunctioning stoma permanence in the treatment of rectal adenocarcinoma
Fernanda Bellotti Formiga, Sabrina Miotto, Galdino José Sitônio Formiga, Odilon Victor Porto Denardin
Journal of Coloproctology.2013; 33(04): 196. CrossRef

Conventional Linear versus Purse-string Skin Closure after Loop Ileostomy Reversal: Comparison of Wound Infection Rates and Operative Outcomes: Jung Ryeol Lee, Young Wan Kim, Jong Je Sung, Ok-Pyung Song, Hyung Chul Kim, Cheol-Wan Lim, Gyu-Seok Cho, Jun Chul Jung, Eung-Jin Shin; J Korean Soc Coloproctol. 2011;27(2):58-63. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.58

9,414 View
66 Download
34 Citations

Abstract PDF

Purpose

Wound infection after an ileostomy reversal is a common problem. To reduce wound-related complications, purse-string skin closure was introduced as an alternative to conventional linear skin closure. This study is designed to compare wound infection rates and operative outcomes between linear and purse-string skin closure after a loop ileostomy reversal.

Methods

Between December 2002 and October 2010, a total of 48 consecutive patients undergoing a loop ileostomy reversal were enrolled. Outcomes were compared between linear skin closure (group L, n = 30) and purse string closure (group P, n = 18). The operative technique for linear skin closure consisted of an elliptical incision around the stoma, with mobilization, and anastomosis of the ileum. The rectus fascia was repaired with interrupted sutures. Skin closure was performed with vertical mattress interrupted sutures. Purse-string skin closure consisted of a circumstomal incision around the ileostomy using the same procedures as used for the ileum. Fascial closure was identical to linear closure, but the circumstomal skin incision was approximated using a purse-string subcuticular suture (2-0 Polysorb).

Results

Between group L and P, there were no differences of age, gender, body mass index, and American Society of Anesthesiologists (ASA) scores. Original indication for ileostomy was 23 cases of malignancy (76.7%) in group L, and 13 cases of malignancy (77.2%) in group P. The median time duration from ileostomy to reversal was 4.0 months (range, 0.6 to 55.7 months) in group L and 4.1 months (range, 2.2 to 43.9 months) in group P. The median operative time was 103 minutes (range, 45 to 260 minutes) in group L and 100 minutes (range, 30 to 185 minutes) in group P. The median hospital stay was 11 days (range, 5 to 4 days) in group L and 7 days (range, 4 to 14 days) in group P (P < 0.001). Wound infection was found in 5 cases (16.7%) in group L and in one case (5.6%) in group L (P = 0.26).

Conclusion

Based on this study, purse-string skin closure after a loop ileostomy reversal showed comparable outcomes, in terms of wound infection rates, to those of linear skin closure. Thus, purse-string skin closure could be a good alternative to the conventional linear closure.

Citations

Citations to this article as recorded by

Incisional Negative Pressure Wound Therapy Versus Primary Wound Suturing after Intestinal Ostomy Closure: A Systematic Review and Meta-Analysis
Michał Kisielewski, Karolina Richter, Magdalena Pisarska-Adamczyk, Michał Wysocki, Nikola Kłos, Tomasz Stefura, Tomasz Wojewoda, Wojciech M. Wysocki
Advances in Wound Care.2025; 14(4): 199. CrossRef
Risk Factors for Postoperative Complications of Ileostomy Reversal
Si-Qi Li, Quan Lv, Zheng Xiang, Xiao-Su Hui
Journal of Laparoendoscopic & Advanced Surgical Techniques.2025; 35(8): 664. CrossRef
Higher BMI increases risk of stoma-site incisional hernia and other complications following diverting loop ileostomy and reversal: a systematic review and meta-analysis
Kaiser O’Sahil Sadiq, Swetha Lakshminarayanan, Patricia Ruiz Cota, Eugenia Marquez Castillo
Surgical Endoscopy.2025; 39(8): 5198. CrossRef
Primary closure of ileostomy site after irrigation with betaine–polyhexanide: a case series
Henry Krasner, Abigail W Cheng, Lance Horner, Ovunc Bardakcioglu
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure
Deng-Yong Xu, Bing-Jun Bai, Lina Shan, Hui-Yan Wei, Deng-Feng Lin, Ya Wang, Da Wang
World Journal of Gastrointestinal Surgery.2024; 16(1): 186. CrossRef
Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial
Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Comparison of modified gunsight suture technique and traditional interrupted suture in enterostomy closure
Chang Chen, Xiang Zhang, Zhi-Qiang Cheng, Bin-Bin Zhang, Xin Li, Ke-Xin Wang, Yong Dai, Yan-Lei Wang
World Journal of Gastroenterology.2023; 29(29): 4571. CrossRef
Wound Infection After Ileostomy Closure: An Interim Analysis of a Prospective Randomized Study Comparing Primary Versus Circumferential Subcuticular Closure Techniques
Sumesh Kaistha, Rajesh Panwar, Sujoy Pal, Nihar Ranjan Dash, Peush Sahni, Tushar Kanti Chattopadhyay
Surgical Infections.2023; 24(9): 797. CrossRef
A comparison of surgical site infections in children after stoma reversal between purse-string and linear closure
Chanathip Sayuen, Ratiyaporn Phannua, Sinobol Chusilp, Patchareeporn Tanming, Suchat Areemit, Katawaetee Decharun, Paisarn Vejchapipat, Kanokrat Thaiwatcharamas
Pediatric Surgery International.2022; 38(1): 149. CrossRef
Comparative study of wound healing following purse-string closure versus conventional linear closure for stoma reversal
Vivek Kumar Roy, Pradeep Jaiswal, Mukesh Kumar, Sukalyan Saha Roy, Saumya Sinha, Anjili Kumari, Krishna Gopal
Southeast Asian Journal of Case Report and Review.2022; 9(1): 1. CrossRef
COMPARISON BETWEEN OSTOMY CLOSURE USING PURSE-STRING VERSUS LINEAR IN CHILDREN
Shahnam Askarpour, Mehran Peyvasteh, Farbod Farhadi, Hazhir Javaherizadeh
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2022;[Epub] CrossRef
Gunsight sutures significantly reduce surgical-site infection after ileostomy reversal compared with linear sutures
Chuang-Kun Li, Wei-Wen Liang, Huai-Ming Wang, Wen-Tai Guo, Xiu-Sen Qin, Jie Zhao, Wen-Bin Zhou, Yang Li, Hui Wang, Rong-Kang Huang
Gastroenterology Report.2021; 9(4): 357. CrossRef
Evidence-based adoption of purse-string skin closure for stoma wounds
Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi
Medical Journal Armed Forces India.2020; 76(2): 185. CrossRef
Purse-string vs. linear skin closure at loop ileostomy reversal: a systematic review and meta-analysis
M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi
Techniques in Coloproctology.2019; 23(3): 207. CrossRef
The Effectiveness of Contralateral Drainage in Reducing Superficial Incisional Surgical Site Infection in Loop Ileostomy Closure: Prospective, Randomized Controlled Trial
Anna Serracant, Xavier Serra‐Aracil, Laura Mora‐López, Anna Pallisera‐Lloveras, Sheila Serra‐Pla, Alba Zárate‐Pinedo, Salvador Navarro‐Soto
World Journal of Surgery.2019; 43(7): 1692. CrossRef
Does Wound Irrigation with Clorhexidine Gluconate Reduce the Surgical Site Infection Rate in Closure of Temporary Loop Ileostomy? A Prospective Clinical Study
Mustafa Goztok, Mustafa Cem Terzi, Tufan Egeli, Naciye Cigdem Arslan, Aras Emre Canda
Surgical Infections.2018; 19(6): 634. CrossRef
Purse-string skin closure versus linear skin closure techniques in stoma closure: a comprehensive meta-analysis with trial sequential analysis of randomised trials
Shahab Hajibandeh, Shahin Hajibandeh, Andrew Kennedy-Dalby, Sheik Rehman, Reza Arsalani Zadeh
International Journal of Colorectal Disease.2018; 33(10): 1319. CrossRef
Construction and Closure of Umbilical Ileostomy in Laparoscopic Rectal Surgery
Masahiro Hada, Masanori Kotake, Daiki Kakiuchi, Kengo Hayashi, Sho Yamada, Koichiro Sawada, Masahiro Oshima, Yosuke Kato, Chikashi Hiranuma, Yuko Yamada, Chiharu Hiraki, Takuo Hara
The Japanese Journal of Gastroenterological Surgery.2017; 50(11): 857. CrossRef
Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial
Mina Alvandipour, Babak Gharedaghi, Hamed Khodabakhsh, Mohammad Yasin Karami
Annals of Coloproctology.2016; 32(4): 144. CrossRef
Subcutaneous vacuum drains reduce surgical site infection after primary closure of defunctioning ileostomy
Hong-Da Pan, Lin Wang, Yi-Fan Peng, Ming Li, Yun-Feng Yao, Jun Zhao, Tian-Cheng Zhan, Chang-Zheng Du, Jin Gu
International Journal of Colorectal Disease.2015; 30(7): 977. CrossRef
Temporary Diverting Ileostomy via the Umbilicus: a Small Case Series
C. D. Mushaya, Raaj Chandra, Wendy Sansom, James Keck
International Surgery.2015; 100(3): 436. CrossRef
Laparoscopic Versus Open Loop Ileostomy Reversal: Is there an Advantage to a Minimally Invasive Approach?
Monica T. Young, Grace S. Hwang, Gopal Menon, Timothy F. Feldmann, Mehraneh D. Jafari, Fariba Jafari, Eden Perez, Alessio Pigazzi
World Journal of Surgery.2015; 39(11): 2805. CrossRef
Clinical Trial on the Incidence of Wound Infection and Patient Satisfaction After Stoma Closure: Comparison of Two Skin Closure Techniques
Sang Il Yoon, Sun Mi Bae, Hwan Namgung, Dong Guk Park
Annals of Coloproctology.2015; 31(1): 29. CrossRef
Comparison of surgical techniques for stoma closure: A retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal
YUMA WADA, NORIKATSU MIYOSHI, MASAYUKI OHUE, SHINGO NOURA, SHIKI FUJINO, KEIJIROU SUGIMURA, HIROFUMI AKITA, MASAAKI MOTOORI, KUNIHITO GOTOH, HIDENORI TAKAHASHI, SHOGO KOBAYASHI, TAKESHI OHMORI, YOSHIYUKI FUJIWARA, MASAHIKO YANO
Molecular and Clinical Oncology.2015; 3(3): 619. CrossRef
A beneficial effect of purse-string skin closure after ileostomy takedown: A retrospective cohort study
Yong Joon Suh, Ji Won Park, Yong Sok Kim, Sung Chan Park, Jae Hwan Oh
International Journal of Surgery.2014; 12(6): 615. CrossRef
Abdominal Wall Closure After a Stomal Reversal Procedure
Manuel López-Cano, José Antonio Pereira, Borja Villanueva, Francesc Vallribera, Eloy Espin, Manuel Armengol Carrasco, María Antonia Arbós Vía, Xavier Feliu, Salvador Morales-Conde
Cirugía Española (English Edition).2014; 92(6): 387. CrossRef
Cierre de la pared abdominal después del cierre de un estoma temporal
Manuel López-Cano, José Antonio Pereira, Borja Villanueva, Francesc Vallribera, Eloy Espin, Manuel Armengol Carrasco, María Antonia Arbós Vía, Xavier Feliu, Salvador Morales-Conde
Cirugía Española.2014; 92(6): 387. CrossRef
The use of purse-string skin closure in loop ileostomy reversals leads to lower wound infection rates—a single high-volume centre experience
Nils Habbe, Sabine Hannes, Juliane Liese, Guido Woeste, Wolf Otto Bechstein, Christoph Strey
International Journal of Colorectal Disease.2014; 29(6): 709. CrossRef
Pursestring Closure of the Stoma Site Leads to Fewer Wound Infections
Janet T. Lee, Thao T. Marquez, Daniel Clerc, Olivier Gie, Nicolas Demartines, Robert D. Madoff, David A. Rothenberger, Dimitrios Christoforidis
Diseases of the Colon & Rectum.2014; 57(11): 1282. CrossRef
Complications after Loop Ileostomy Closure: A Retrospective Analysis of 132 Patients
Eligijus Poskus, Edvinas Kildusis, Edgaras Smolskas, Marijus Ambrazevicius, Kestutis Strupas
Visceral Medicine.2014; 30(4): 276. CrossRef
Randomized controlled trial: comparison of two surgical techniques for closing the wound following ileostomy closure: purse string vs direct suture
N. Dusch, D. Goranova, F. Herrle, M. Niedergethmann, P. Kienle
Colorectal Disease.2013; 15(8): 1033. CrossRef
Influence of skin closure technique on surgical site infection after loop ileostomy reversal: Retrospective cohort study
C.D. Klink, M. Wünschmann, M. Binnebösel, H.P. Alizai, A. Lambertz, G. Boehm, U.P. Neumann, C.J. Krones
International Journal of Surgery.2013; 11(10): 1123. CrossRef
Purse-string approximation is superior to primary skin closure following stoma reversal: a systematic review and meta-analysis
D. P. McCartan, J. P. Burke, S. R. Walsh, J. C. Coffey
Techniques in Coloproctology.2013; 17(4): 345. CrossRef
Primary linear closure with closed suction wound drain after ileostomy takedown
Mi Kyoung Hong, Min-Su Park, Sun Jin Park, Kil Yeon Lee
Korean Journal of Clinical Oncology.2013; 9(1): 38. CrossRef

Review

Controversies in Pouch Surgery for Ulcerative Colitis.: Yu, Chang Sik; J Korean Soc Coloproctol. 2009;25(3):207-211.; DOI: https://doi.org/10.3393/jksc.2009.25.3.207

16,192 View
12 Download

Abstract PDF: Restorative proctocolectomy (RPC) has become a standard procedure over 30 yr in patients with ulcerative colitis and familial adenomatous polyposis. However, there are several controversies in surgical method and strategy. From oncological point of view, mucosal proctectomy and hand-sewn ileal pouch anal anastomosis has advantage because of relatively complete removal of columnar epithelium. However, long-term follow-up results after stapled anastomosis revealed extremely low incidence of dysplasia in the anal transitional zone (ATZ). Furthermore, recent publication of 26 cancer occurrence after RPC showed more prevalence in mucosectomy group. Risk factors of dysplasia after RPC are supervening cancer or dysplasia on the proximal colon, long duration of symptom, and history of primary sclerosing cholangitis. Preservation of ATZ by stapled anastomosis may have functional superiority, which is supported by some manometric and functional studies. However, two randomized controlled trials showed no difference between the groups. Although there are some surgeons who advocate one stage RPC, majority of centers prefer two stage RPC with ileostomy. According to meta-analysis one stage RPC revealed 2-3 times frequent anastomotic leakage or pelvic sepsis. Five to ten percent of ulcerative colitis has some pathologic characteristics of Crohn's disease, which is classified as indeterminate colitis (IC). Long-term results of RPC in patients with IC revealed similar results with ulcerative colitis and superior to Crohn's disease. So RPC may be justified in patients with IC. Conclusively, RPC should be tailored according to clinicopathologic details and operative findings.

Original Articles

Analysis of Results after Percutaneous Catheter Drainage for Anastomotic Leakage.: Hwang, Sang Il , Kim, Hungdai , Han, Won Kon; J Korean Soc Coloproctol. 2008;24(4):260-264.; DOI: https://doi.org/10.3393/jksc.2008.24.4.260

2,073 View
9 Download

Abstract PDF: PURPOSE
Anastomotic leakage is a serious and life- threatening complication after colorectal surgery. The management of clinical anastomotic leakage remains largely operative. The aim of this study was to analyze the clinical characteristics and the natural history of percutaneous catheter drainage (PCD) for anastomotic leakage after colorectal surgery.
METHODS
Twenty patients who were managed by PCD after anastomotic leakage between January 2002 and December 2006 were studied. Charts were reviewed for information on clinical characteristics and biolologic finding prePCD and postPCD.
RESULTS
Anastomotic leakage was managed by using only PCD in 16 of 20 patients (80%), and twenty percent of patients (4/20) were managed by using a loop ileostomy after PCD. Nine patients (45%) had peritoneal drains left in place at diagnosis. Before PCD, the mean of the peak white blood cell (WBC) was 12,800/mm3, and the mean period of fever (>38degrees C) was 3.4 (2~5) days. After PCD, the mean time until the body temperature dropped below 37oC was 3.1 (1~5) days, the mean time until the WBC count dropped below 10,000/mm3 was 3.2 (0~6) days, the mean duration of ileus and diarrhea was 3.3 (0~6) days, the mean total amount of drainage during 6 days was 880 cc, and the mean length of stay after PCD was 14.9 days.
CONCLUSIONS
PCD is a safe and effective method for treating anastomtic leakage in patients without sepsis or diffuse peritonitis and with CT scans that reveal no diffuse fluid collection.

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

2,538 View
40 Download
3 Citations

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.

Citations

Citations to this article as recorded by

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
Influences of Symptom Experience and Depression on Quality of Life in Colorectal Cancer Patients with Stoma Reversal
Jung Ha Kim, Hyunjung Kim
Journal of Korean Biological Nursing Science.2015; 17(4): 306. CrossRef
The Influence of Nutritional Assessment on the Outcome of Ostomy Takedown
Min Sang Kim, Ho Kun Kim, Dong Yi Kim, Jae Kyun Ju
Journal of the Korean Society of Coloproctology.2012; 28(3): 145. CrossRef

The Significance of Diverting Ileostomy during Restorative Proctocolectomy.: Hong, Dong Hyun , Yu, Chang Sik , NamGung, Hwan , Cho, Young Kyu , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2002;18(6):386-389.

1,461 View
37 Download

Abstract PDF: PURPOSE
Restorative proctocolectomy (RP) is a standard surgery in patients with ulcerative colitis and familial adenomatous polyposis. Usually, diverting ileostomy is performed to protect an ileoanal anastomosis with RP. However, there are many controversies whether diverting ileostomy might urgently be needed. This study was performed to compare postoperative complications after RP with or without diverting ileostomy.
METHODS
Between July 1994 and June 2001, 77 (M : F= 45 : 32) patients underwent RP. The indication criteria for diverting ileostomy included tension at the anastomosis, positive leakage test, compromised blood flow in the ileal pouch, long-term and high-dose steroid use, and severe rectal inflammation in ulcerative colitis patients.
RESULTS
Histopathologic diagnoses revealed 45 ulcerative colitis, 23 familial adenomatous polyposis, 5 rectal cancer, and 4 hereditary nonpolyposis colorectal cancer. Diverting ileostomies were performed in 40 patients (51.9%) and closed approximately 4 months later. Fourty eight complications were present in 32 patients. There was no perioperative death. There was no difference in perioperative outcome, morbidity or functional status between patients with and without ileostomy. However, in ulcerative colitis patients, anastomosis leakage was more frequent in patients without ileostomy.
CONCLUSIONS
Restorative proctocolectomy can be safely performed without diverting ileostomy in most cases of RP. However, diverting ileostomy may reduce anastomosis leakage in patients with ulcerative colitis.

Is Barium Enema Prior to Ileostomy Closure Necessary?.: Lee, Min Ro , Lee, Min Joo , Kim, Jong Hun , Hwang, Yong; J Korean Soc Coloproctol. 2006;22(5):298-300.

4,795 View
22 Download

Abstract PDF: PURPOSE
A barium enema is frequently performed to check for healing prior to ileostomy closure, but there have been reports that ileostomy closure without a contrast study is safe in selected patients. The aim of this study was to assess the necessity of a routine barium enema prior to ileostomy closure.
METHODS
Between January 1994 and June 2005, 51 patients with a temporary loop ileostomy who had a barium enema prior to ileostomy closure at Chonbuk National University Hospital were retrospectively reviewed. These patients were divided into 2 groups, the protective ileostomy group and the ileostomy-after-leakage group. To examine the necessity of a routine barium enema prior to ileostomy closure, we assessed whether the barium enema results changed management and whether there were pelvic sepsis and obstructive symptoms following ileostomy closure.
RESULTS
In the protective ileostomy group (n=39), the barium enema was performed after a mean of 59 days (range: 27~151 days). There were no abnormal findings at the barium enema, no schedule changes, no pelvic sepsis, and no obstructive symptoms following ileostomy closure. In the ileostomy-after-leakage group (n=12), the barium enema was performed after a mean of 54 days (range: 30~82 days). In 2 patients, with barium enemas at 33 days and 36 days, an anastomotic leakage was found, and ileostomy closure was delayed.
CONCLUSIONS
In patients with a protective ileostomy, a barium enema prior to ileostomy closure is unnecessary, but in patients with an ileostomy after leakage, barium enema should be considered.

Clinical Analysis of Complications in Abdominal Stoma Surgery.: Lee, Hun , Oh, Jae Hwan; J Korean Soc Coloproctol. 2001;17(2):64-68.

1,354 View
41 Download

Abstract PDF: PURPOSE
This study was undertaken to review the complications associated with ileostomy, colostomy construction and subsequent closure.
METHODS
We retrospectively reviewed 74 patients with ileostomy and colostomy closure from August 1, 1995 to June 30, 1999.
RESULTS
The complications of stoma construction occurred in 15 patients (20.3%) among 74 patients: skin problem in 10 cases, prolapse in 4 cases, and stoma necrosis, retraction and stenosis in 1 case, respectively. Factors such as age, underlying pathology, type of stoma did not contribute to the complications of stoma construction. Complications of stoma closure occured in 15 patients (20.3%): wound problem in 9 cases, enterocolitis in 4 cases and anastomotic leakage in 2 cases. With respect to stoma closure, only old age was associated with increased morbidity (P<0.05), rather than method of closure, time interval to closure, or type of stoma. Mean operation time for simple closure was 122.2 minutes and 204 minutes for resection and anastomosis. The mean hospital stay was 9.6 days for simple closure and 13 days for resection and anastomosis.
CONCLUSIONS
The morbidity associated with stoma construction and subsequent closure was appreciable. There were no specific risk factors influencing the complications of ileostomy or colostomy construction, but old age increased morbidity after closure.

An Antiperistaltic Ileostomy on Total Proctocolectomy in familial Adenomatous.: Oh, Nahm Gun; J Korean Soc Coloproctol. 1997;13(3):413-420.

1,240 View
1 Download

Abstract PDF: Permanent ileostomy is usually recommended in the cases of total proctolectomy for cancerous change on the distal rectum from ulcerative colitis or familial adenomatous polyposis, but fecal content through conventional ileostomy is usually liquid or semiliquid. Sometimes, it accompanies dehydration and some nutrient loss as complication. So, the author has devised namely, "antiperistaltic ileostomy" for formed stool evacuation. About 25cm length of the most dismal ileum was cut and this distal segment was reversed with intact mesentery and then antiperistaltic ileostomy was performed. The author has performed antiperistaltic ilestomy in 5 cases of familial adenomatous polyposis, or ulcerative colitis with a cancerous change in the low rectum for the past 5 years at the Department of Surgery in Pusan National University Hospital. The results obtained were as follows. 1) In theantiperistaltic ileostomy, the 24-hour ileostomy discharge was averagely 748 cc, in contrast to 1124 cc from conventional one. 2) In terms of weight, the 24-hour evacuated material from the conventional ileostomy weighed 810 gm on the average, but only 540 gm from the antiperistaltic ileostomy. 3) The 24-hour filtered liquid through a coffee filter of the 24-hour ileostomy discharge weighed averagely 514 gm in the conventional group, which was 63.5% of the prefiltered discharge, and weighed averagely 160 gm in the antiperistaltic group, which was 29.6% of the 24-hour discharge. In conclusion, the antiperistaltic ileostomy is claimed to create the effect of a reservoir by producing intestinal stasis in the segment, forming bacterial proliferation. The antiperistaltic ileostomy as a terminal segment is effective in reducing the daily amount of stool and facilitates stoma care owing to diminished liquid component in the ileostomy discharge.

Evaluation of the Usefulness of Loop Ileostomy during Low Anterior Resection or.: Kim, Ho Young , Kim, Ik Yong , Kim, Sang Hee , Yoon, Kwang Soo; J Korean Soc Coloproctol. 1997;13(3):397-402.

1,493 View
6 Download

Abstract PDF: This is a retrospective clinical analysis of the usefulness of loop ileostomy for the prevention of anastomotic leakage in patients with low rectal cancer when the low anterior resection or coloanal anastomosis is performed. We reviewed 54 cases of low rectal cancer from January 1994 to May 1996 at Department of Surgery, Wonju College of Medicine, Yonsei University. In 54 cases of low rectal cancer, 28 cases were ileostomy group and 17 cases were no stoma group. There were no differences in clinical characteristics such as age and sex distribution. Most patients were classified into stage B or C by modified Astler-Coiler classification but 2 cases of stage D that simultaneous liver resection was performed were in no stoma group. Tumor locations from the anal verge were 6.8 and 10.3 cm by mean in ileostomy and no stomp group, respectively(P<0.05). Heights of anastomosis were 3.7 and 6.8 cm by mean from the anal verge in ileostomy and no stoma group, respectively(P<0.05). Double stapling technique was used for anastomosis in most patients but hand-sewn technique was also carried out in 1 case in ileostomy group. The most common postoperative minor complication was wound infection in both groups. Anastomotic leakage rate was higher in no stoma group(4 of 17, 23.5%) than that of ileostomy group (1 of 28, 3.6%) but statistical comparison could not be confirmed(P=0.00). But interestingly, such complications as stoma perforation, stoma prolapse and parastomal hernia were developed in ileostomy group and that all complications should be corrected by ileostomy repair. As forementioned above, we had concluded that ileostomy could protect anastomosis site but above mentioned complications associated with building the stoma should be also prevented by careful surgical technique.

Ileostomy Related Complications.: Song, Gi Won , Yu, Chang Sik , Lee, Hae Ok , Kim, Mi Sook , Namgung, Hwan , Lee, Gang Hong , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2003;19(2):82-89.

1,827 View
45 Download

Abstract PDF: PURPOSE
Ileostomy may affect various aspects of life style of the patient. Moreover the complication after ileostomy formation or closure may lower the life quality of the patient. The purpose of this study is to investigate ileostomy related complications and elucidate associated factors.
METHODS
We recruited 103 patients who underwent ileostomy in Asan Medical Center between July 1989 and June 2000. All ileostomies are constructed through the rectus muscle at the right lower quadrant of the abdomen. To mnimize peristomal skin irritation, at least two to three centimeters of the ileum lies above the skin level. We analyzed complications after ileostomy formation in relation to underlying diseases, types and purpose of ileostomy. Also, we analyzed complication after ileostomy closure in relation to underlying diseases, time interval and method of take-down.
Results
are compared using chi-square test. Statistical significance was assigned to a P value of<0.05.
RESULTS
Complications of ileostomy formation were developed in 17 (16.5%) cases; 8 peristomal dermatitis, 3 wound infection, 2 prolapse, 1 stenosis, 1 perforation, 1 bleeding, 1 high output ileostomy. There was no significant difference of complication rate in relation to underlying diseases, types and purpose of ileostomy. Ileostomy take-down was performed in 55 (53.4%) cases of 103 patients. Complications related with ileostomy take-down were developed in 18 (32.7%) cases; 7 wound infection, 5 intestinal obstruction, 2 incisional hernia, 2 enterocutaneous fistula, 1 anastomosis leakage, 1 bleeding. There was no significant difference of complication rate in relation to time interval or method of take-down. However, complication rate of ileostomy take-down was significantly increased in patient with inflammatory bowel disease.
CONCLUSIONS
Ileostomy formation is simple and safe surgical procedure. We couldn't find any factor affecting the morbidity of ileostomy formation or closure. However, complication rate after ileostomy closure, especially in patient with inflammatory bowel disease, is relatively high.

First
Prev
Page of 1
Next
Last

Search