Laparoscopic Versus Open Loop Ileostomy Reversal: Is there an Advantage to a Minimally Invasive Approach?

Young, Monica T.; Hwang, Grace S.; Menon, Gopal; Feldmann, Timothy F.; Jafari, Mehraneh D.; Jafari, Fariba; Perez, Eden; Pigazzi, Alessio

doi:10.1007/s00268-015-3186-2

Cited by 17 publications

(11 citation statements)

References 49 publications

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“…10 Moreover, more recently, it is now conventional to conduct entirely laparoscopic procedures, and laparoscopic diverting ileostomy has been widespread and reported as a useful surgical procedure for low anterior resection of rectal cancer. 11,12 Although the closure of a colostomy or ileostomy requires less invasive surgery in general than the initial surgery, postoperative complications occur in 24.6% to 48% of cases overall. 13,14 Moreover, combining the closure of stoma in patients with risk factors including diabetes and obesity compels us to consider how we might mitigate complications as far as possible.…”

Section: Discussionmentioning

confidence: 99%

Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report

Kita

Mori

Tanabe

et al. 2020

Asian J Endoscop Surgery

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Introduction: In closure of a stoma, the small working space and adhesions hinder a precise surgical procedure, compared with conventional approaches to digestive surgery. The aim of this prospective study was to introduce a new technique of laparoscopic stoma closure (LASC). Materials and surgical techniques: After starting with three trocars, it is a priority to dissect around the arising ileum; a linear stapler is precisely inserted in both orifices of the loop stoma and applied two times, extracorporeally. Ultimately, both the oral and anal sides of the loop ileum are cut and closed using a linear cutter stapler in a delta-shaped manner just under the abdominal wall, intracorporeally. Eventually, the arising stoma is removed using an intraabdominal and cutaneous approach. Discussion: LASC for patients with a temporary loop ileostomy is safe and feasible. More data and experience will be required to verify the benefits of this new technique.

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Section: Discussionmentioning

confidence: 99%

Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report

Kita

Mori

Tanabe

et al. 2020

Asian J Endoscop Surgery

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“…studied adhesions in patients who underwent laparoscopy after a previous colectomy. They found fewer adhesions in patients who had previously undergone laparoscopic resections compared to those following open surgery, but multiple studies comparing adhesion formation after laparoscopic or open surgery have reported conflicting results both in animal models and in human studies …”

Section: Discussionmentioning

confidence: 99%

Loop ileostomy reversal after laparoscopic versus open rectal resection

Sebastian

Stupart

Watters

2018

ANZ Journal of Surgery

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Background: One of the potential advantages of laparoscopic abdominal surgery is in reducing the development of adhesions, making later surgery easier. The purpose of this study is to determine whether using the laparoscopic versus open approach for a rectal resection with a diverting ileostomy affects the speed and safety of subsequent ileostomy reversal. Methods: This is a retrospective study using patients who underwent ileostomy reversal following a rectal cancer resection with curative intent with a diverting ileostomy at the University Hospital Geelong between January 2006 and June 2017. Demographic information, operative technique and histological staging for the initial resection were recorded. Theatre time and complication rates for the ileostomy reversal were also recorded. Results: A total of 82 patients were included in this study (22 had laparoscopic resections as the primary operation, 50 had open resections and 10 had laparoscopic converted to open resections). The three groups were similar in age, body mass index, American Society of Anesthesiologists score and proportion undergoing chemoradiotherapy. Median (range) theatre time for ileostomy reversal was 118 (50-200) min after a laparoscopic resection, 80 (30-360) min after a laparoscopic converted to open resection and 65 (50-160) min after an open resection (P = 0.009). Complication rates after ileostomy reversal were similar between the three groups (P = 0.97). Conclusion: Ileostomy reversal took longer to perform if the primary rectal resection was performed laparoscopically. © 2018 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E52-E55 ANZJSurg.com © 2018 Royal Australasian College of Surgeons E54Sebastian et al.

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“…72 Regarding stoma reversal, laparoscopic ileostomy reversal has recently been proposed as an alternative to conventional open closure through the ileostomy site, with the benefit of laparoscopic hernia repair or prevention with mesh placement. In a retrospective cohort study comparing laparoscopic versus open ileostomy reversal in 53 patients versus 80 patients whose index case was performed either open, laparoscopically, or robotically, 73 the laparoscopic reversal group was associated with significantly longer operative time due to adhesiolysis and concurrent stoma site mesh reinforcement for hernia prevention. No conversion occurred in the laparoscopic group and no significant differences were noted in blood loss, LOS, or overall morbidity between the groups.…”

Section: Reoperative Minimally Invasive Surgery For Stoma Reversalmentioning

confidence: 99%

“…No conversion occurred in the laparoscopic group and no significant differences were noted in blood loss, LOS, or overall morbidity between the groups. 73 Unlike laparoscopic ileostomy closure, laparoscopic Hartmann's reversal has significant benefits over the open approach. In a systematic review of 35 studies on Hartmann's reversal in a total of 6,249 patients, 396 were reversed laparoscopically and 5,853 using an open approach.…”

Section: Reoperative Minimally Invasive Surgery For Stoma Reversalmentioning

confidence: 99%

Role of Minimally Invasive Surgery in the Reoperative Abdomen or Pelvis

Feigel

Sylla

2016

Clinics in Colon and Rectal Surgery

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Laparoscopy has become widely accepted as the preferred surgical approach in the management of benign and malignant colorectal diseases. Once considered a relative contraindication in patients with prior abdominal surgery (PAS), as surgeons have continued to gain expertise in advanced laparoscopy, minimally invasive approaches have been increasingly incorporated in the reoperative abdomen and pelvis. Although earlier studies have described conversion rates, most contemporary series evaluating the impact of PAS in laparoscopic colorectal resection have reported equivalent conversion and morbidity rates between reoperative and non-reoperative cases, and series evaluating the impact of laparoscopy in reoperative cases have demonstrated improved short-term outcomes with laparoscopy. The data overall highlight the importance of case selection, careful preoperative preparation and planning, and the critical role of surgeons' expertise in advanced laparoscopic techniques. Challenges to the widespread adoption of minimally invasive techniques in reoperative colorectal cases include the longer learning curve and longer operative time. However, with the steady increase in adoption of minimally invasive techniques worldwide, minimally invasive surgery (MIS) is likely to continue to be applied in the management of increasingly complex reoperative colorectal cases in an effort to improve patient outcomes. In the hands of experienced MIS surgeons and in carefully selected cases, laparoscopy is both safe and efficacious for reoperative procedures in the abdomen and pelvis, with measurable short-term benefits.

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Laparoscopic Versus Open Loop Ileostomy Reversal: Is there an Advantage to a Minimally Invasive Approach?

Abstract: LIR is safe and effective with low perioperative morbidity and mortality. The use of laparoscopy as an option in terms of concomitant hernia repair and lysis of adhesions may be considered in selected patients.

Cited by 17 publications

References 49 publications

Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report

Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report

Loop ileostomy reversal after laparoscopic versus open rectal resection

Role of Minimally Invasive Surgery in the Reoperative Abdomen or Pelvis

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