Kajsa Gustavsson1, Ulf Gunnarsson, Pia Jestin. 1. Department of Surgical Gastroenterology, Karolinska University Hospital, Huddinge, Karolinska Institutet, 141 85, Stockholm, Sweden. kajsa.gustafsson@karolinska.se
Abstract
PURPOSE: The aim of this study was to compare three methods for closure of a diverting ileostoma according to development of postoperative small-bowel obstruction (SBO) and anastomotic leakage (AL). METHODS: Complications arising within 30 days after closure of a defunctioning loop ileostomy in 351 patients during the period 1999-2006 were studied retrospectively by evaluation of case records. The techniques employed were: hand-sewn anastomosis without bowel resection, hand-sewn anastomosis with bowel resection and stapled anastomosis. RESULTS: Of the 351 patients, 149 had a hand-sewn anastomosis without bowel resection (HS), 70 had a hand-sewn anastomosis with bowel resection (HSR) and 132 patients had a stapled anastomosis (S). The total number of SBOs was 44 patients (12.5%). In the two hand-sewn groups, 15.5% (34 patients) suffered postoperative SBO compared to 7.6% (10 patients) in the stapled group (p = 0.029). No difference in AL could be found between the groups, where the overall frequency was 2.8% (10 patients). Median hospital stay was 6 days in the HS group, 5 days in the HSR group and 4 days in the S group (p = 0.001). CONCLUSION: In the present study, stapled anastomosis was associated with a lower frequency of postoperative SBO and a shorter hospital stay compared to sutured anastomosis (either with or without a short small-bowel resection) after closure of a diverting ileostoma.
PURPOSE: The aim of this study was to compare three methods for closure of a diverting ileostoma according to development of postoperative small-bowel obstruction (SBO) and anastomotic leakage (AL). METHODS: Complications arising within 30 days after closure of a defunctioning loop ileostomy in 351 patients during the period 1999-2006 were studied retrospectively by evaluation of case records. The techniques employed were: hand-sewn anastomosis without bowel resection, hand-sewn anastomosis with bowel resection and stapled anastomosis. RESULTS: Of the 351 patients, 149 had a hand-sewn anastomosis without bowel resection (HS), 70 had a hand-sewn anastomosis with bowel resection (HSR) and 132 patients had a stapled anastomosis (S). The total number of SBOs was 44 patients (12.5%). In the two hand-sewn groups, 15.5% (34 patients) suffered postoperative SBO compared to 7.6% (10 patients) in the stapled group (p = 0.029). No difference in AL could be found between the groups, where the overall frequency was 2.8% (10 patients). Median hospital stay was 6 days in the HS group, 5 days in the HSR group and 4 days in the S group (p = 0.001). CONCLUSION: In the present study, stapled anastomosis was associated with a lower frequency of postoperative SBO and a shorter hospital stay compared to sutured anastomosis (either with or without a short small-bowel resection) after closure of a diverting ileostoma.
Authors: S A García-Botello; J García-Armengol; E García-Granero; A Espí; C Juan; F López-Mozos; S Lledó Journal: Dig Surg Date: 2005-01-19 Impact factor: 2.588
Authors: Thorsten Löffler; Inga Rossion; Käthe Gooßen; Daniel Saure; Jürgen Weitz; Alexis Ulrich; Markus W Büchler; Markus K Diener Journal: Langenbecks Arch Surg Date: 2014-12-25 Impact factor: 3.445