G M Fuhrman1, D M Ota. 1. Department of General Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
Abstract
PURPOSE: We report our early experiences with laparoscopic intestinal stomas, describing the indications, the surgical techniques, and the complications of this new procedure. METHODS: The medical records of the 17 patients who had successfully undergone laparoscopic intestinal diversion at The University of Texas M. D. Anderson Cancer Center were reviewed. RESULTS: The mean follow-up of this group has been 24.3 (range, 3-61) weeks. Seven patients had their stomas created as part of a laparoscopic abdominoperineal resection, six patients underwent palliative laparoscopic colostomy for an obstructing tumor of the rectum, or a colorectal-genitourinary fistula, and four patients treated by local excision of a rectal cancer were believed to require proximal protecting fecal diversion. All six patients treated with palliative intent experienced successful relief from their obstruction or fistula, and were able to resume enteral nutrition. Complications included prolapse in one patient and paracolostomy hernia in another. Neither complication required furthur operative correction. Pneumoperitoneum was established in all patients using an open technique. CONCLUSIONS: Laparoscopy is a well-tolerated and effective method of creating intestinal stomas for a variety of indications. As more experience is gained with this procedure, we anticipate that laparoscopy will become the preferred method of establishing intestinal diversion.
PURPOSE: We report our early experiences with laparoscopic intestinal stomas, describing the indications, the surgical techniques, and the complications of this new procedure. METHODS: The medical records of the 17 patients who had successfully undergone laparoscopic intestinal diversion at The University of Texas M. D. Anderson Cancer Center were reviewed. RESULTS: The mean follow-up of this group has been 24.3 (range, 3-61) weeks. Seven patients had their stomas created as part of a laparoscopic abdominoperineal resection, six patients underwent palliative laparoscopic colostomy for an obstructing tumor of the rectum, or a colorectal-genitourinary fistula, and four patients treated by local excision of a rectal cancer were believed to require proximal protecting fecal diversion. All six patients treated with palliative intent experienced successful relief from their obstruction or fistula, and were able to resume enteral nutrition. Complications included prolapse in one patient and paracolostomy hernia in another. Neither complication required furthur operative correction. Pneumoperitoneum was established in all patients using an open technique. CONCLUSIONS: Laparoscopy is a well-tolerated and effective method of creating intestinal stomas for a variety of indications. As more experience is gained with this procedure, we anticipate that laparoscopy will become the preferred method of establishing intestinal diversion.