Laparoscopic Incisionless Stoma Creation for Patients With Colorectal Malignant Stricture

Tanaka, Eiji; Fukunaga, Yosuke; Nakashima, Masayuki; Nagasue, Yasutomo; Akiyoshi, Takashi; Konishi, Tsuyoshi; Nagayama, Satoshi; Fujimoto, Yoshiya; Ueno, Masashi; Yamaguchi, Toshiharu

doi:10.1097/sle.0b013e3182a834bf

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Fecal diversion may be required for a various number of conditions, and is sometimes the sole practice in the abdominal cavity, particularly when a resection-anastomosis or repair procedure is not the case. For these instances, different techniques have been described for stoma creation without a laparotomy or insertion of additional trocars (1)(2)(3)(4)(5)(12)(13)(14). Trephine stoma has been proposed years ago, and different variations have been described (2,5,11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Trephine stoma has been proposed years ago, and different variations have been described (2,5,11,12). The introduction of the SILS port from the stoma site have been shown to be feasible, since the exploration is practicable and the most suitable bowel segment is easy to detect with the laparoscopic examination of the abdominal cavity (3,13). Direct positioning of the camera through the stoma site without the insertion of a trocar has been also proposed as gasless laparoscopic-assisted intestinal stoma creation technique (5).…”

Section: Discussionmentioning

confidence: 99%

“…Fecal diversion is necessitated for various benign or malignant conditions. Although stoma creation has traditionally required laparotomy, various minimal invasive techniques have been proposed to decrease the physiological burden of surgery (1)(2)(3)(4)(5). Laparoscopic stoma creation has been used for over two decades as an alternative technique to the conventional open stoma construction, since it has shown to be associated with shorter hospital stay, less postoperative analgesia requirement, and shorter time to flatus, bowel movement and tolerance of a solid diet (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Case series and reports have described the variations of this technique, and have used further attempts including blunt finger dissection or insertion of camera through incision for further exploration (4,5). Single incision laparoscopic surgery (SILS) trocars have been used through planned stoma site for the same purpose (3,13). Some have also used colonoscopy for assisting the stoma creation (2).…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Imaging Guided No-Laparotomy vs Conventional Diverting Colostomy: A Multi-Institutional Case-Control Study

Haksal¹,

Okkabaz²,

Şeker³

et al. 2019

Kocaeli Med J

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GİRİŞ ve AMAÇ:Geleneksel saptırıcı kolostomi tekniği ile laparotomisiz kolostomi tekniklerini karşılaştırmak ve laparotomisiz teknikte ameliyat öncesi görüntüleme tetkiklerinin faydasını göstermek amaçlanmıştır. YÖNTEM ve GEREÇLER: Laparotomisiz hasta grubunda doğru stoma yerinin tespiti için 3 boyutlu bilgisayarlı tomografi (BT) ve düz grafi tetkikleri kullanıldı. Bu hastaların sonuçları ile başka bir merkezde laparotomi ile saptırıcı kolostomi açılan hastaların sonuçları karşılaştırıldı. BULGULAR: Laparotomisiz kolostomi uygulanan 18 hasta ve laparotomili kolostomi uygulanan 16 hasta çalışmaya dahil edildi. Demografik veriler ile birçok hasta ve işlem ilişkili parametre benzer bulundu. İnsizyon boyutu (4.8±0.8 karşın 13.3±1.9cm, p<0.001) operasyon süresi (31.4±13.0 karşın 46.7±7.9dk, p<0.001) cerrahi alan enfeksiyonu (0 vs 4 [25%], p=0.039) ve yatış süresi (4 [3-30] karşın 5 [4-34]gün, p=0.01) laparotomisiz grupta anlamlı olarak daha az idi. TARTIŞMA ve SONUÇ: Saptırıcı kolostomi oluşturulmasında laparotomisiz teknik güvenli ve yararlı olabilir. Laparotomide sakınılarak insizyon boyutu, operasyon süresi ve yatış süreleri kısaltılıp cerrahi alan enfeksiyonları azaltılabilir. Mevcut çalışma, laparotomisiz kolostomi planlanan hastalarda görüntüleme yöntemlerinden yararlanılmasını önermektedir. Anahtar Kelimeler: kolostomi, laparotomisiz, tomografi, fekal diversiyon, cerrahi ABSTRACT INTRODUCTION:We aimed to compare the outcomes of no-laparotomy and conventional diverting colostomy techniques and to describe the process and benefits of using preoperative imaging tools in no-laparotomy procedure. METHODS:Patients intended to receive no-laparotomy diverting colostomy, have preoperative imaging tools of 3D computerized tomography and X-ray examinations in order to predict the best location for the stoma construction. The perioperative outcomes in these cases were compared with those obtained from the patients operated with conventional diverting colostomy with laparotomy at another institution. RESULTS: Eighteen and 16 patients had a diverting colostomywith no-laparotomy technique after preoperative assessment, and conventional procedure. Demographics and most of the patient-and procedure-related factors were similar. Length of incision, (4.8±0.8 vs. 13.3±1.9cms, p<0.001) operation time (31.4±13.0 vs 46.7±7.9mins, p<0.001) and the rate of surgical site infection (0 vs 4 [25%], p=0.039) and hospitalization period (4 [3-30] vs 5 [4-34]days, p=0.01) were significantly less in no-laparotomy group. DISCUSSION and CONCLUSION: No-laparotomy technique may be safe and beneficial while performing a diverting colostomy. Length of incision, operation time and hospitalization period are shortened if a laparotomy is avoided, and the rate of surgical site infection decreases. Current study recommends preoperative imaging tools when a no-laparotomy technique is intended.P Pr re eo op pe er ra at ti if f G Gö ör rü ün nt tü ül le em me e K Kı ıl la av vu uz zl lu uğ ğu un nd da a L La ap pa ar ro ot to om mi is si iz z v ve e K Kl ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative Imaging Guided No-Laparotomy vs Conventional Diverting Colostomy: A Multi-Institutional Case-Control Study

Haksal¹,

Okkabaz²,

Şeker³

et al. 2019

Kocaeli Med J

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Short-term Outcomes After Open and Laparoscopic Colostomy Creation

Ivatury

Rosenzweig

Holubar

2016

Diseases of the Colon &Amp; Rectum

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Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings

Kang

Cho²,

et al. 2020

Ann Coloproctol

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Original ArticleAnn Coloproctol 2020;36(1):17-21 https://doi.org/10. 3393/ac.2019.04.25 Purpose: Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy. Methods: Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed. Results: Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41-83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37-118 minutes), and the median length of hospital stay was 8 days (range, 2-211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0-4 days). All stomas had good function, and there was no 30-day mortality. Conclusion: Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

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Laparoscopic Incisionless Stoma Creation for Patients With Colorectal Malignant Stricture

Abstract: A laparoscopic single-site approach to stoma creation may be a feasible option in fecal diversion.

Cited by 3 publications

References 14 publications

Preoperative Imaging Guided No-Laparotomy vs Conventional Diverting Colostomy: A Multi-Institutional Case-Control Study

Preoperative Imaging Guided No-Laparotomy vs Conventional Diverting Colostomy: A Multi-Institutional Case-Control Study

Short-term Outcomes After Open and Laparoscopic Colostomy Creation

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings

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