Loop stoma allows reducing the percentage of anastomotic leak and re-operation caused bythis complication. Our department has performed the loop stoma on a skin bridge since 2011.
The aim of the study was to evaluate the early results of treatment after the skin bridge loop stoma creation in comparison with the stoma made on a plastic rod. Both groups had 20 patients.
Material and methods. The study involved 40 patients with ileostomy, operated 2010-2013. We evaluated 20 patients with a loop ileostomy on a plastic rod, compared to 20 other patients with a skinbridge ileostomy. The study included 24 men and 16 women. Median age was 68.3. All evaluated patients were previously operated due to rectal cancer.
Results. It has been shown that the surgical site infection is more common in the group with a plastic rod (5 vs 1 patient). Inflammation of the skin around the stoma occurred in 18 patients (90%) in the first group, while no such complication was found in patients in the second group. The average number of exchanged ostomy wafers was 2,9 per weekin the first group of patients, and 1,1 in the second group (p 0,05).
Conclusions. The creation of the skin bridge stoma allows for tight fit of the ostomy appliance immediately after surgery completion. The equipment has stable and long-lasting contact with the skin, no skin inflammatory changes occur. Also the surgical site infection rates are lower in this group of patients. As perioperative patient does not require an increased number of ostomy appliance, the cost of treatment can be considered as an important aspect.
1. Van de Wall BJ, Draaisma WA, Schouten ES et al.: Conventional and laparoscopic reversal of the Hartmann procedure: a review of literature. J GastrointestSurg. 2010; 14(4): 743-52.
2. Cohen ME, B.K., Ko CY, Hall BL: Development of an American College of Surgeons National Surgery Quality Improvement Program: morbidity and mortality risk calculator for colorectal surgery. J Am Coll Surg 2009; 208(6): 1009-10.
3. Hackam DJ, Rotstein OD: Stoma closure and wound infection: an evaluation of risk factors. Can J Surg. 1995; 38(2): 144-48.
4. Patil V, Vijayakumar A, Ajitha MB, Kumar SL: Comparison between tube ileostomy and loop ileostomy as a diversion procedurê. ISRN Surgery 2012; article ID 547523.
5. Chen J, Zhang Y, Jiang Ch et al.: Temporary ileostomy versus colostomy for colorectal anastomosis: evidence from 12 studies. Scan J Gastroenterol 2013; 48: 556-62
6. S aini P, Gaba R, Faridi MS et al.: Quality of life of patients after temporary ieostomy for ileal perforation - a questionnaire based study. Indian J Surg 2014; 76: 38-43.
7. Dziki Ł: Stomia pêtlowa na mostku skórnym. Technika operacyjna. Pol Przegl Chir 2014; 86(9):448-50.
8. Bugiantella W, Rondelli F, Mariani L et al.: Traditional lateral ileostomy versus percutaneous ileostomy by exclusion probe for the protection of extraperitonealcolo-rectal anastomosis: The ALPPI (Anastomotic Leak Prevention by Probe Ileostomy) trial. A randomized controlled trial. ESJO 2014; 40: 476-83.
9. Beck S: Stoma issues in the obese patient. Clinics in Colon and Rectal Surg 2011; 24: 4.
10. Phatak UR, Kao LS, You YN et al.: The impact of ileostomy-related complications on the mulitidisciplinary treatment of rectal cancer. Ann Surg Oncol 2014; 21(2): 507-12.