Peter C Ambe1,2, Hubert Zirngibl3, Gabriela Möslein4. 1. Department of Surgery, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany. Peter.ambe@helios-kliniken.de. 2. Center for Hereditary Tumor Diseases, Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany. Peter.ambe@helios-kliniken.de. 3. Department of Surgery, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany. 4. Center for Hereditary Tumor Diseases, Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany.
Abstract
BACKGROUND: Anastomotic leakage (AL) is the most feared complication in colorectal surgery. A diverting ileostomy is routinely used to prevent or reduce morbidity and mortality following AL. However, a diverting ileostomy cannot prevent AL. Besides, diverting ileostomy might be associated with relevant complications. Herein, we introduce the virtual ileostomy as an alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP). MATERIALS AND METHODS: The results of eight patients, five females and three males with a median age of 19.5 ± 6.0 years (range 16.0-31.0 years), undergoing restorative proctocolectomy with IPAA and virtual ileostomy for FAP are presented. RESULTS: All cases were laparoscopically managed. The virtual ileostomy was released between postoperative day 7 and 9. No AL was registered. Postoperative recovery was uneventful in all cases. CONCLUSION: A diverting ileostomy was prevented via the use of virtual ileostomy in all cases. Thus, virtual ileostomy is a good alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with IPAA for FAP.
BACKGROUND: Anastomotic leakage (AL) is the most feared complication in colorectal surgery. A diverting ileostomy is routinely used to prevent or reduce morbidity and mortality following AL. However, a diverting ileostomy cannot prevent AL. Besides, diverting ileostomy might be associated with relevant complications. Herein, we introduce the virtual ileostomy as an alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP). MATERIALS AND METHODS: The results of eight patients, five females and three males with a median age of 19.5 ± 6.0 years (range 16.0-31.0 years), undergoing restorative proctocolectomy with IPAA and virtual ileostomy for FAP are presented. RESULTS: All cases were laparoscopically managed. The virtual ileostomy was released between postoperative day 7 and 9. No AL was registered. Postoperative recovery was uneventful in all cases. CONCLUSION: A diverting ileostomy was prevented via the use of virtual ileostomy in all cases. Thus, virtual ileostomy is a good alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with IPAA for FAP.
Authors: Marco Sacchi; Pietro D Legge; Pietro Picozzi; Francesco Papa; Capuano Loreto Giovanni; Luigi Greco Journal: Hepatogastroenterology Date: 2007-09
Authors: Alberto Vega Hernández; Jakob Otten; Hildegard Christ; Christoph Ulrici; Elvin Piriyev; Sebastian Ludwig; Claudia Rudroff Journal: In Vivo Date: 2022 May-Jun Impact factor: 2.406