Satisfactory short-term outcome of total laparoscopic loop ileostomy reversal in obese patients: a comparative study wit
- PDF / 990,439 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 35 Downloads / 168 Views
ORIGINAL ARTICLE
Satisfactory short‑term outcome of total laparoscopic loop ileostomy reversal in obese patients: a comparative study with open techniques Hao Su1 · Shou Luo1 · Zheng Xu1 · Chuanduo Zhao1 · Mandula Bao1 · Xishan Wang1 · Zhixiang Zhou1 · Haitao Zhou1 Received: 7 August 2020 / Accepted: 17 September 2020 © Italian Society of Surgery (SIC) 2020
Abstract Reversal of loop ileostomy after colorectal surgery in obese patients can be challenging and total laparoscopic (TLAP) approach may be beneficial. This study aims to compare short-term outcomes of TLAP and open approaches in obese patients undergoing loop ileostomy reversal after laparoscopic-assisted colorectal surgery. A retrospective review was performed for consecutive patients who underwent laparoscopic-assisted colorectal surgery previously and underwent loop ileostomy reversal between January 2017 and April 2020. TLAP and open cases performed in obese patients were identified and compared for the following outcomes: baseline characteristics, operative outcomes, postoperative recovery, and postoperative complications. TLAP or open-loop ileostomy reversal was performed on 30 and 34 patients, respectively. TLAP approach was associated with a similar operation time and blood loss compared with an open approach (P > 0.05). The median length of incision for stoma removal was significantly shorter in the TLAP group than in the open group (6.5 cm vs. 8.5 cm; P 28 kg/m2 were deemed obese in China. All patients included in this study were 18 years of age or older and received stoma reversal at least 3 months after primary surgery or ongoing adjuvant therapy. Exclusion criterion included any loop ileostomy operations that featured ancillary procedures such as complex abdominal wall repair, additional bowel resection, or anastomotic revision. Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule were also caused for exclusion. In the latter half of 2018, our group changed operating protocol, preferring, where possible, to perform a TLAP loop ileostomy reversal rather than an open reversal. In the first month, two open reversal was performed and, thereafter, the TLAP loop ileostomy reversal was performed in all patients except one due to a deficiency of equipment. Cases recruited in this study were stratified into two groups: TLAP loop ileostomy reversal with intracorporeal anastomosis and open reversal. The study was conducted in accordance
13
Fig. 1 Trocar placement and the size of the trocars
Updates in Surgery
Fig. 2 Surgical procedures of anastomosis in the TLAP loop ileostomy reversal. a The transection of the ileum proximal and distal to the stoma; b inside view of the stoma after the transection of the
ileum; c the two intestinal walls were approximated and joined; d the enterotomy was closed with one linear stapler
small incisions (10 mm) were made along the curvature of the two broken ends of the intestines at the anti-mesenteric side. The int
Data Loading...
