Short-Term Outcome of Loop Ileostomy Closure Under Local Anesthesia: Results of a Feasibility Study
Tóm tắt
Loop ileostomy is an established technique for temporary deviation of bowel contents to avoid clinical anastomotic leakage, fistulas, or use of an inflamed colon. Anesthetic risks and postoperative complications of the closure operation result in a significant proportion of ileostomies that are never closed, factors that should be borne in mind when fashioning temporary stomas. We investigated loop ileostomy closure under local anesthesia as a way to avoid these problems. As a feasibility study, 15 successive patients underwent closure of a loop ileostomy under local anesthesia. The patients’ experience of the procedure, postoperative pain, analgesia requirements, and oral intake were prospectively evaluated. Procedures could be comfortably completed under safe doses of local anesthesia. Use of standard nasogastric tubes was avoided and immediately postoperatively patients were able to resume a full oral diet. Discharge was on the second postoperative day (median). Complications were paralytic ileus for two days (1 patient), anastomotic leakage (1 patient), and superficial wound infection (1 patient). Reversal of loop ileostomy can be performed safely and comfortably under local anesthesia. Postoperative results compare favorably with those of routine procedures.
Tài liệu tham khảo
NS Williams DG Nasmyth D Jones AH Smith (1986) ArticleTitleDefunctioning stomas: a prospective controlled trial comparing loop ileostomy with loop transverse colostomy Br J Surg 73 566–70 Occurrence Handle1:STN:280:BimB2s%2FotVw%3D Occurrence Handle3524742
S Fasth L Hulten (1984) ArticleTitleLoop ileostomy: a superior diverting stoma in colorectal surgery World J Surg 8 401–7 Occurrence Handle1:STN:280:BiuB2snivVY%3D Occurrence Handle6464495
HD van dePavoordt VW Fazio DG Jagelman IC Lavery FL Weakley (1987) ArticleTitleThe outcome of loop ileostomy closure in 293 cases Int J Colorect Dis 2 214–7 Occurrence Handle1:STN:280:BieD1cbitVU%3D
CM Bailey JM Wheeler M Birks R Farouk (2003) ArticleTitleThe incidence and causes of permanent stoma after anterior resection Colorectal Dis 5 331–4 Occurrence Handle1:STN:280:DC%2BD3s3oslCisw%3D%3D Occurrence Handle12814411
AW Gooszen RH Geelkerken J Hermans MB Lagaay HG Gooszen (1998) ArticleTitleTemporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy Surgery 88 76–9
SM Feinberg RS McLeod Z Cohen (1987) ArticleTitleComplications of loop ileostomy Am J Surg 153 102–6 Occurrence Handle10.1016/0002-9610(87)90209-1 Occurrence Handle1:STN:280:BiiD1Mjnt1A%3D Occurrence Handle3799885
A Senapati RJ Nicholls JK Ritchie CJ Tibbs PR Hawley (1993) ArticleTitleTemporary loop ileostomy for restorative proctocolectomy Br J Surg 80 628–30 Occurrence Handle1:STN:280:ByyB1MbmtFY%3D Occurrence Handle8518908
MF Kalady RC Fields S Klein KC Nielson CR Manyth KA Ludwig (2003) ArticleTitleLoop ileostomy closure at an ambulatory surgery facility: a safe and cost-effective alternative to routine hospitalization Dis Colon Rectum 46 486–90 Occurrence Handle10.1007/s10350-004-6587-0 Occurrence Handle12682542