Sang-Hun Jung1, Jae-Hwang Kim. 1. Department of Surgery, College of medicine, Yeungnam University, 170 Hyunchung-ro, Nam-gu, Daegu 705-717, Korea. 98jshgs@hanmail.net
Abstract
BACKGROUND:Ileostomy closure is a minor procedure and is performed through a small peristomal incision. However, a hard adhesion increases the technical difficulty. A peritoneofascial suture (PFS) will reduce the adhesion layers of the abdominal wall. This study was performed to evaluate whether the PFS method may decrease the extent of adhesions between the bowel and the abdominal wall opening and facilitate ileostomy mobilization. METHODS:Forty-two patients (24 males and 18 females) with a mean age of 57 years (range = 31-80 years) and who were undergoing ileostomy closure were enrolled. The PFS group and the conventional group had 18 and 24 patients, respectively. The intraoperative findings such as degree of adhesion, mobilization time, and associated bowel injury were analyzed. RESULTS: The thickness of the abdominal wall and the rectus abdominis was similar in both groups. The overall operation time was shorter in the PFS group than in the conventional group (50.9 vs. 80.4 min, respectively, p = 0.001). The ileostomy mobilization time was also shorter in the PFS group than in the conventional group (18.9 vs. 44.7 min, respectively, p < 0.001). The procedure was technically easier in the PFS group more frequently than in the conventional group (77.8 % vs. 31.6 %, respectively, p = 0.013). Bowel injury during mobilization was more common in the conventional group than in the PFS group (50.0 % vs. 16.7 %, respectively, p = 0.053). CONCLUSIONS: The peritoneofascial suture method is a simple procedure, and it may facilitate ileostomy mobilization by decreasing adhesion layers. To confirm the technical advantage of this method a randomized study will be needed.
RCT Entities:
BACKGROUND: Ileostomy closure is a minor procedure and is performed through a small peristomal incision. However, a hard adhesion increases the technical difficulty. A peritoneofascial suture (PFS) will reduce the adhesion layers of the abdominal wall. This study was performed to evaluate whether the PFS method may decrease the extent of adhesions between the bowel and the abdominal wall opening and facilitate ileostomy mobilization. METHODS: Forty-two patients (24 males and 18 females) with a mean age of 57 years (range = 31-80 years) and who were undergoing ileostomy closure were enrolled. The PFS group and the conventional group had 18 and 24 patients, respectively. The intraoperative findings such as degree of adhesion, mobilization time, and associated bowel injury were analyzed. RESULTS: The thickness of the abdominal wall and the rectus abdominis was similar in both groups. The overall operation time was shorter in the PFS group than in the conventional group (50.9 vs. 80.4 min, respectively, p = 0.001). The ileostomy mobilization time was also shorter in the PFS group than in the conventional group (18.9 vs. 44.7 min, respectively, p < 0.001). The procedure was technically easier in the PFS group more frequently than in the conventional group (77.8 % vs. 31.6 %, respectively, p = 0.013). Bowel injury during mobilization was more common in the conventional group than in the PFS group (50.0 % vs. 16.7 %, respectively, p = 0.053). CONCLUSIONS: The peritoneofascial suture method is a simple procedure, and it may facilitate ileostomy mobilization by decreasing adhesion layers. To confirm the technical advantage of this method a randomized study will be needed.
Authors: Zane Cohen; Anthony J Senagore; Merril T Dayton; Mark J Koruda; David E Beck; Bruce G Wolff; Phillip R Fleshner; Richard C Thirlby; Kirk A Ludwig; Sergio W Larach; Eric G Weiss; Joel J Bauer; Lena Holmdahl Journal: Dis Colon Rectum Date: 2005-06 Impact factor: 4.585