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

Abstract

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.

Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea

“…With the rapid growth of minimally invasive surgery in recent years, efforts have been made to reduce surgical trauma and enhance cosmetic outcomes, leading to the development of single-port laparoscopic surgery for various diseases [ 8 – 10 ]. Single-port laparoscopic appendectomy (SPLA) was initially presented by Esposito in 1998 [ 11 ] with the potential benefits of improved cosmetic outcomes, less postoperative pain, and avoidance of hemorrhagic complications from potential injury to the epigastric arteries.…”

“…With the rapid growth of minimally invasive surgery in recent years, efforts have been made to reduce surgical trauma and enhance cosmetic outcomes, leading to the development of single-port laparoscopic surgery for various diseases [8][9][10].…”